Dyspepsia in primary care: perceived causes, reasons for improvement, and satisfaction with care

While dyspepsia is a common problem in primary care populations, very little is known about patient perceptions of medical care for this disease. The present study of patients with dyspepsia treated by primary care physicians looks at causes, procedures, and reasons for improvement from the patient's viewpoint and relates these factors to patient satisfaction with family physicians' medical care.

Medical chart and billing data were collected for 545 adult patients who visited five family health centers for digestive complaints during a 6-month period in 1993. A questionnaire was completed by 288 patients 6 to 8 weeks after patient's index visit. Baseline findings are reported.

The two most common causes of gastrointestinal problems were attributed to stress or anxiety (58%) and diet (46%). Between the time of the index visit and the baseline survey, 48% reported that they had recovered or improved. Of those who recovered or improved, most (75%) credited "taking GI medicine" followed by change in diet (44%). Patients who reported recovery or improvement of their gastrointestinal complaints (P < .001) and older patients (P = .032) were the most satisfied with overall medical care. Satisfaction with medical care was not associated with insurance coverage, procedures done, race, antiulcer medication treatment, diagnosis, general health status, or sex.

Specific health status, ie, improvement of gastrointestinal (GI) problems, predicted patient satisfaction for 70% of cases in this study. Most patients who improved credited GI medicines for their improvement, and those who improved were more satisfied with their medical care.