Search

The need for indicators of health care access that are compatible with changing information and their implications for survey design and the increased emphasis on access problems of specific groups are discussed. Service use relative to health care need, care measure structures and consumer perspectives are identified as the indicators of health care access. The implications of expanding the role of surveys in health care program and insurance plan programs are also assessed., Efforts to evaluate "access to healthcare" have been central to judgments rendered on the success or shortcomings of health systems for many years now. Although the issue is familiar, conceptualizing [...]

Objective. To identify personal characteristics and factors related to health and patterns of healthcare utilization associated with the elderly people's satisfaction with medical care. Data Sources/Study Setting. Data from the 1991 Medicare Current Beneficiary Survey (MCBS) on 8,859 persons age 65 and over living in the community. Study Design. Items reflecting general satisfaction with care and views of physician quality are examined and, based on factor analysis, grouped in dimensions of two (global quality, access) and three (technical skills, interpersonal manner, information-giving), respectively. The relationship of high levels of satisfaction in each dimension to personal characteristics of elderly people, and to measures of access and utilization, is assessed using logistic regression. Principal Findings. While satisfaction is high, with over 90 percent surveyed expressing some satisfaction, there is substantial variation with less likelihood of high satisfaction among those 80 or older, with less education and income and in poorer health. Longer waiting time at visits and less frequent visits are factors in lower satisfaction as well. A favorable perception of physician quality, especially regarding technical skills, appears to play a significant role in satisfaction with global quality of care. Conclusions. Studies of patient satisfaction in elderly people are rare. Some factors expected to be related to positive assessment based on earlier studies, were, e.g., better health and shorter waiting time, while others were not, e.g., increasing age. Elderly people appear to place greater importance on physician technical skills, as opposed to interpersonal dimensions, in assessing global quality. These findings suggest the need for a better understanding of how elderly people evaluate care and what they value in interactions with the healthcare system. Key Words. Elderly, patient satisfaction, quality of care, With increasing competition in the healthcare market and growing interest in assessing patient outcomes, satisfaction measures are increasingly used by healthcare providers and health policymakers in evaluating the performance of [...]