Factor for The Dissatisfaction of Patient for Emergency Department Services

ABSTRACT

PURPOSE: To evaluate patient satisfaction with emergency department (ED) services and to identify factors influencing dissatisfaction. METHODS: Direct interviews with questionnaires were administered at 18 EDs during a 6-day period from July 26 to July 31, 2006. All patients and accompanying persons who visited the ED during the survey period were included. Questionnaires consisted of 14 questions regarding the patient's characteristics (determinants), 9 questions about ED services (components) evaluated on a 5-point Likert scale, and 2 questions to gauge overall ED satisfaction rated on a 5-point Likert scale and a visual analogue scale (VAS). Overall dissatisfaction was modeled using logistic regression. RESULTS: Of the 708 patients visiting ED during the survey period, 322 patients consented to an interview (response rate 45.5%), including 286 who gave complete responses. Among the 286 complete responses, 177 indicated an overall satisfaction of ED service, rating it at 79.2% on the VAS. The determinant "number of ED visits >1 for last 1 year" and all questions in the components category were related to overall dissatisfaction. In logistic regression modeling, the determinants "age> or =45 years" and "number of ED visits >1 for last 1 year" correlated with overall dissatisfaction. In the final model, dissatisfaction with the comfort of the waiting room (OR=2.6, 95% CI1.3-5.0), care received from the physicians (OR=4.0, 95% CI2.0-8.3), care received from the nurses (OR=3.6, 95% CI1.6-7.7), and waiting time to receipt of treatment (OR=5.8, 95% CI2.9-11.3) were all related to overall dissatisfaction. CONCLUSION: In order to reduce dissatisfaction with ED services, EMS policies should be formulated to improve care by physicians and nurses and to decrease the perceived waiting time.