Patient Satisfaction With Care for Urgent Health Problems: A Survey of Family Practice Patients

Michelle Howard; James Goertzen; Brian Hutchison; Janusz Kaczorowski; Kelly Morris

doi:10.1370/afm.704

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Table 1.

Demographic Characteristics and Self-Reported Health of 1,227 Patients With an Urgent Health Problem in the Past 6 Months Who Used Different Services

Characteristic	Family Physician (n=201)	After-Hours Clinic (n=93)	Emergency Department (n=677)	Walk-in Clinic (n=94)	Telephone Advisory Service (n=35)	More Than 1 Service (n=127)
* N = 131 did not respond.
† N = 27 did not respond.
‡ N = 16 did not respond.
Age, mean (SD), y	47.8, 21.0	41.8, 24.5	43.4, 24.1	38.7, 23.7	31.3, 25.4	36.6, 23.5
Proxy respondent for child >17 y, % (n)	12.9 (26)	24.7 (23)	20.2 (137)	25.5 (24)	45.7 (16)	26.8 (34)
Female, % (n)	59.2 (119)	70.0 (65)	57.3 (388)	66.0 (62)	71.4 (25)	67.7 (86)
Income ≥$45,000, % (n)*	54.4 (99)	61.8 (55)	53.2 (322)	65.9 (54)	72.7 (24)	60.3 (70)
Some or completed high school education, % (n)^†	91.3 (178)	93.5 (87)	88.3 (587)	92.2 (83)	91.4 (32)	96.0 (119)
Self-reported health status, % (n)^‡
Excellent	15.5 (31)	29.0 (27)	16.0 (107)	25.3 (23)	22.9 (8)	23.0 (29)
Very good	36.0 (72)	31.2 (29)	32.2 (215)	34.1 (31)	37.1 (13)	26.2 (33)
Good	32.0 (64)	28.0 (26)	32.5 (217)	27.5 (25)	28.6 (10)	33.3 (42)
Fair	11.0 (22)	8.6 (8)	13.6 (91)	8.8 (8)	5.7 (2)	14.3 (18)
Poor	3.2 (4)	3.2 (3)	5.7 (38)	4.4 (4)	5.7 (2)	3.2 (4)

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Table 2.

Adjusted Mean Satisfaction Score for Care for Most Recent Urgent Health Problem Among 1,227 Patients Who Used Different Services

Site of Service*	Adjusted Score^† Mean (SE)	95% CI
Note: Scores are based on a Likert scale in which 7 = very satis3 ed, 1 = very dissatisfied.
SE=standard error; CI=confidence interval.
* For site of care, F_5,1,073=7.67; P<.001; eta²=.05.
† Adjusted for age, sex, self-reported health status, education, and income.
‡ Significantly (P <.004) higher satisfaction compared with patients who used emergency department, walk-in clinic, telephone health advisory service, or more than service.
§ Statistically significantly (P <.004) higher satisfaction compared with patients who used a walk-in clinic or more than 1 service.
¶ Statistically significantly (P <.004) higher satisfaction compared with patients who used more than 1 service.
Family physician^‡	6.1 (0.14)	5.8–6.4
After-hours clinic^§	5.6 (0.20)	5.2–6.0
Emergency department^¶	5.3 (0.08)	5.2–5.5
Telephone health advisory service	4.8 (0.32)	4.2–5.5
Walk-in clinic	4.7 (0.21)	4.3–5.1
More than 1 service	4.7 (0.17)	4.4–5.0

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The Article in Brief

Patient Satisfaction With Care for Urgent Health Problems: A Survey of Family Practice Patients

Michelle Howard, MSc , and colleagues

Background The goal of this study is to better understand patients� satisfaction with care for urgent health problems provided in different settings. The study is based on a survey mailed to family practice patients.

What This Study Found Patients� satisfaction with after-hours care for an urgent problem is higher if provided by their own family doctor or their doctor�s after-hours clinic, compared with a walk-in clinic, the emergency department, and telephone health advisory services. According to a survey of 1,227 patients from 36 practices in Thunder Bay, Ontario, who were asked to rate their satisfaction on a 7-point scale, patients reported highest satisfaction when care was received from their own family doctor (6.1), followed by an after-hours clinic affiliated with their doctor (5.6). Those who received care at a walk-in clinic or who used more than one service reported the lowest satisfaction rating (4.7).

Implications

As health systems emphasize improved access to medical care and ongoing patient care, this study can inform the development of new models of after-hours care.
The authors suggest that these findings support increasing financial and human resources to increase access to practice-based primary care services.