Baker, Richard H.; (1996) The measurement of patient satisfaction in general practice. Doctoral thesis (M.D), UCL (University College London).

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Abstract

The problems addressed in this study were the lack of valid, reliable measures of patient satisfaction for use in British general practice, the lack of information about the characteristics of practices, general practitioners and patients that influence patient satisfaction and the lack of a theory or model of patient satisfaction. Methods (i) Development of two questionnaires, the surgery satisfaction questionnaire (SSQ) and the consultation satisfaction questionnaire (CSQ) following the identification of appropriate questions and pilot tests to identify the components of satisfaction and assess internal consistency. A test-retest measure of reliability was undertaken. The criterion validity of SSQ was assessed and the construct validity of both CSQ and SSQ evaluated. (ii) Administration of SSQ to patients in 99 practices and CSQ to patients consulting 190 general practitioners, and the collection of information about the practices, general practitioners and patients. (iii) Development and assessment of a pragmatic model of patient satisfaction. Results (i) SSQ included 26 questions concerned with general satisfaction with the practice, accessibility, availability, continuity, medical care and premises. CSQ included 18 questions concerned with general satisfaction with the consultation, professional care, depth of relationship and perceived length of the consultation. Evidence was obtained to indicate that SSQ and CSQ were reliable and valid. (ii) 17,799 patients completed SSQ and 11,447 completed CSQ. Levels of satisfaction varied and were not uniformly high. Patients are more satisfied if they receive care from smaller practices that have personal list systems. (iii) The pragmatic model should be revised to take into account the importance to patients of a personal service. Conclusions Valid and reliable measures of satisfaction can be developed and in future the use of unevaluated measures should be avoided. General practitioners need to consider how they could organise their practices to provide a personal service to their patients.

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