User satisfaction is influenced by the interval between a health care service and the assessment of the service

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Abstract

In order to improve the quality of patient care, questionnaires are often used to identify user’s experiences and evaluations, but only a few studies have examined whether measuring user satisfaction at different time points influences the assessment of health care. Several studies have shown equivalency between paper and electronic patient reported outcomes; however, none of these studies have considered the fact that electronic questionnaires are usually completed at the hospital, while paper questionnaires are typically completed at home weeks after the visit. In order to ensure that the comparison of results collected by the two different methods are not biased, the aim of this study was to determine if the interval between an outpatient visit and the assessment of the quality of care influences user satisfaction and to compare response rates between questionnaires completed at different times. In a follow-up study, parents from a paediatric outpatient clinic in Denmark were quasi-randomised to 1 of 3 groups: group 1 completed an electronic questionnaire on a touch screen computer in the outpatient clinic and a paper questionnaire 3–6 weeks after the visit; group 2 completed a paper questionnaire in the outpatient clinic and a paper questionnaire 3–6 weeks after the visit; and group 3 completed a paper questionnaire 3–6 weeks after the visit. A total of 1148 parents completed at least 1 questionnaire. User satisfaction was significantly lower when the assessment was made after a visit to the outpatient clinic compared to an assessment made at the clinic. The response rates of questionnaires completed at the clinic were significantly higher than the response rates of questionnaires completed after the visit. Both the timing of surveys and response rates need to be taken into consideration when planning user surveys. Outcomes from surveys conducted at different times are not readily comparable.

Section snippets

Background

In order to improve the quality of patient care, it is essential to elicit the user’s experience and evaluation (Sitzia & Wood, 1997). Only the patients and relatives experience the course of the illness and the hospitalisation; therefore, they can point out areas with strengths in organization, treatment, and care, and areas with lack of coherence in the process and poor quality (Rubin, 1990, Sitzia and Wood, 1997).

User satisfaction can be assessed in different ways. Qualitative methods, such

Setting

The study was conducted at a Danish paediatric outpatient clinic at Kolding Hospital, which provides outpatient consultations each year for approximately 11,000 children < 18 years of age. The children have diseases representing a broad range of medical diagnoses, from serious chronic diseases to minor ailments.

Population

The parents of all the children consulting a paediatrician at the outpatient clinic during the 9 weeks from September 2008 to November 2008 were included. However, parents who did not

Results

A total of 1148 parents completed at least 1 questionnaire. Fig. 2 presents the inclusion and participation of the parents in the study.

The response rates were 73% (group 1) and 76% (group 2) for questionnaires completed at the outpatient clinic and 53% (group 1), 45% (group 2) and 58% (group 3) for questionnaires completed after the visit. Only 35% and 39% of the parents, respectively, had completed the questionnaire twice and were included in the comparative analyses (Fig. 2). Table 1

Discussion

The study showed that the parents’ perception of the quality of care in a paediatric outpatient clinic depends on when the parents are asked to respond via questionnaire. Indeed, questionnaires completed before leaving the clinic showed a higher level of satisfaction with the visit compared to responses submitted later. The study also showed that higher response rates were obtained for electronic questionnaires and paper questionnaires completed at the outpatient clinic than for paper

Conclusion

The present study showed that the timing of performing a survey has a significant impact on both the level of user satisfaction and on the response rates. This should be taken into consideration when planning a survey of user satisfaction, when comparing user satisfaction from different surveys, and when testing questionnaires.

Acknowledgements

The authors want to thank parents and staff from the paediatric clinic at Kolding Hospital and Kolding Research Committee for supporting the study.

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