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Abstract Background Few studies document differences in patient satisfaction with physicians in the elderly (≥ 65 years) and compare it to non-elderly ( Methods A cross-sectional survey study on a convenience sample of 20,901 patients rated their recent visit to a physician through a web-based survey. Survey included validated questions based on aspects of physician care practice such as "friendliness", wait times and time spent with doctor. These scales were then used to measure patient satisfaction with physician. Statistical analysis involved pair-matching of non-elderly patients with elderly patients (both cohorts, n = 507 each) using propensity scores. Results Even though elderly and non-elderly patients had similar waiting times, elderly patients gave higher physician satisfaction scores than non-elderly patients (all p < 0.05). When predictors of physician satisfaction ratings were examined, shorter waiting time was more significantly associated with better treatment satisfaction in non-elderly patients (partial rho = -0.25 in the non-elderly compared to partial rho = -0.11 in elderly, p < 0.05). Increased time spent with the physician was more significantly correlated with higher physician satisfaction ratings in the non-elderly patients (partial rho = 0.38 in the non-elderly compared to partial rho = 0.18, p < 0.001). Conclusion Increased patient satisfaction ratings of the non-elderly were associated more strongly with shorter waiting times than in the elderly. However overall, elderly patients reported similar waiting times and better physician satisfaction scores. Similarly, higher physician satisfaction in non-elderly patients were more strongly associated with increased time spent with physician than in the elderly patients.

OBJECTIVE.: Although selective serotonin reuptake inhibitors (SSRIs) are considered cost-effective medications for patients with major depressive disorder (MDD), significant dosage adjustments are often necessary when treatment is initiated. Our study was conducted to examine whether dose titration for SSRIs at initiation of therapy was associated with a greater use of health care resources and higher costs. STUDY DESIGN.: A retrospective database analysis was conducted. METHODS.: A nationally representative cohort of individuals with MDD was identified in a large managed care claims database between January 1, 2004, and December 31, 2006. A study-specific titration algorithm was used to identify patients who underwent dose titration, compared with those who did not, within the first eight weeks of initiating SSRI therapy. We calculated propensity scores and identified a 1:1 matched cohort of titration versus non-titration patients. We used univariate and multivariate statistical tests to compare the mean number of therapeutic days, health care service utilization, and expenditures between the two groups during the first eight weeks (56 days) of treatment and six months (180 days) after treatment began. RESULTS.: Over the first eight weeks, the titration cohort had a 32% decrease in the adjusted mean number of therapeutic days (38 vs. 56, respectively; P < 0.001), a 50% increase in depression-related outpatient visits (1.8 vs. 1.2; P < 0.001), a 38% increase in depression-related outpatient costs ($137 vs. $81; P ≤ 0.001), an increase in antidepressant pharmacy costs ($139 vs. $61; P < 0.001), and a 64% increase in psychiatric visits (0.69 vs. 0.42; P = 0.001), compared with the matched non-titration cohort. These differences were consistent among individual SSRI groups as well as during the six-month period. CONCLUSION.: Patients undergoing dose titration of SSRIs at the beginning of therapy consumed more medical resources and spent more days receiving a subtherapeutic dose than a comparable control group without dose titration. Differences in the utilization of resources were consistent with increased patient monitoring in the titration group; however, the added benefit of titration could not be assessed with this database. [ABSTRACT FROM AUTHOR]

Background: Few studies document differences in patient satisfaction with physicians in the elderly (≥ 65 years) and compare it to non-elderly (<65 years) patients. Methods: A cross-sectional survey study on a convenience sample of 20,901 patients rated their recent visit to a physician through a web-based survey. Survey included validated questions based on aspects of physician care practice such as "friendliness", wait times and time spent with doctor. These scales were then used to measure patient satisfaction with physician. Statistical analysis involved pair-matching of non-elderly patients with elderly patients (both cohorts, n = 507 each) using propensity scores. Results: Even though elderly and non-elderly patients had similar waiting times, elderly patients gave higher physician satisfaction scores than non-elderly patients (all p < 0.05). When predictors of physician satisfaction ratings were examined, shorter waiting time was more significantly associated with better treatment satisfaction in non-elderly patients (partial rho = -0.25 in the nonelderly compared to partial rho = -0.11 in elderly, p < 0.05). Increased time spent with the physician was more significantly correlated with higher physician satisfaction ratings in the non-elderly patients (partial rho = 0.38 in the non-elderly compared to partial rho = 0.18, p < 0.001). Conclusion: Increased patient satisfaction ratings of the non-elderly were associated more strongly with shorter waiting times than in the elderly. However overall, elderly patients reported similar waiting times and better physician satisfaction scores. Similarly, higher physician satisfaction in non-elderly patients were more strongly associated with increased time spent with physician than in the elderly patients. [ABSTRACT FROM AUTHOR]