ABSTRACT
BACKGROUND: As stated by Donabedian, the father of quality assurance, satisfaction is an integral component of quality in medical care. Patient satisfaction is an important predictor of health-related behaviors, use of medical services, and health outcomes. Impressive literature exists in examining various aspects of patient satisfaction, however, no study thus far has examined differences in patient satisfaction between first and return visits to primary care physicians. OBJECTIVE: Our interest is to determine whether there are differences in patient satisfaction between first and return visits to primary care physicians, with the hypothesis that patients returning for their visits have a higher satisfaction level compared to their first initial visit. METHODS: The authors conducted a cross-sectional analysis of the national Web-based survey DrScore. Via DrScore, patients anonymously rated their physician on the basis of treatment satisfaction received from their most recent outpatient visit. The association between physician satisfaction and total care patient ratings of first and return visits was assessed via regression analysis. RESULTS: In total, 15,341 patients were included in this study. Our findings indicate that for a 1-unit change from first visit to return visits, the coefficient of patient satisfaction for the return visits is approximately 10 times higher compared to that of the first visit. Furthermore, the mean satisfaction score for the return visit group is higher than that for the first visit group, 80.28 versus 64.48, respectively (P < .05). CONCLUSION: Return visits to primary care physicians are associated with higher patient satisfaction compared to the first initial visit.
ABSTRACT
Stroke risk factors are routinely assessed in community screening programs; however, the rate of patient follow-up for health care once risk factors are identified is known to be low. This study was conducted to test the effectiveness of a brief behavioral telephonic intervention in an ongoing community stroke prevention screening program on health care seeking for stroke risk. A total of 227 participants with 2 or more stroke risk factors were randomly allocated to either an attention control arm or a behavioral intervention arm. The control group received standard information on risk and advice, whereas the intervention group received a brief Health Belief Model telephonic intervention designed to motivate care-seeking. The effect of treatment on the participants who completed a health care visit for stroke risk concerns was assessed using logistic regression. Cox survival analysis was used to compare time to physician visit between the 2 groups. Participants in the intervention arm were 1.85 times more likely to visit a primary care physician than controls. At 3 months, 69.2% of subjects in the intervention arm and 52.9% of those in the controls arm reported a new primary care visit after screening (P = .02), with 56.0% in the intervention arm and 38.4% in the control arm reporting a primary care visit specifically to discuss the stroke screening results (P < .01). Our data indicate that the brief, low-cost, motivational intervention effectively promoted adherence to screening advice and merits further testing.
Subject(s)
Community Health Services , Health Knowledge, Attitudes, Practice , Mass Screening , Patient Acceptance of Health Care , Patient Education as Topic , Primary Health Care , Stroke/prevention & control , Adult , Chi-Square Distribution , Female , Humans , Logistic Models , Male , Mental Recall , Middle Aged , Motivation , North Carolina , Office Visits , Patient Compliance , Proportional Hazards Models , Risk Assessment , Risk Factors , Stroke/etiology , Stroke/psychology , Telephone , Time FactorsABSTRACT
Parkinson's disease (PD) affects nearly 1 million Americans with a mean onset age of 60 years. Its progressive, neurodegenerative nature, causing motor complications and affecting mood, has a considerable impact on a patient's health-related quality of life. Pharmacologic therapies are the most widely utilized treatment. The broad range of drugs for treating PD warrants an assessment of each medication's health-related outcomes, which includes consideration of clinical, economic and patient-centered outcomes. This review seeks to explore the outcomes associated with drugs frequently appearing in the literature of the past 5 years and to comment on the direction of pharmacologic research and management of PD pharmacotherapy in the future.
