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Differences in white and minority patients' satisfaction with care may hinge on satisfaction with physician interaction

In a recent study, a nine-item questionnaire commonly used to measure patient satisfaction with care, the Visit-Specific Satisfaction Questionnaire (VSQ-9), did not identify differences in satisfaction with care between minority and white patients. However, analysis of responses to four VSQ-9 questions that specifically asked about direct interaction with physicians revealed that minority patients were significantly less satisfied with physician interaction than white patients. Measurements of patient satisfaction that use multi-item, composite indicators should also include focused comparisons of satisfaction with the care provided by the physician, concludes Donald A. Barr, M.D., Ph.D., of Stanford University.

In the study, which was supported by the Agency for Healthcare Research and Quality (HS09350), Dr. Barr compared responses to the VSQ-9 for overall patient satisfaction with a four-item subset of the VSQ-9 dealing with the quality of the direct physician-patient interaction. Participants were 537 highly educated primary care patients from an affluent area of California who completed the questionnaire during an office visit to one of the study physicians. For all nine questions of the VSQ-9 instrument, patients had to rate their responses from 1 for poor to 5 for excellent.

The first four questions pertained to satisfaction with access to care (waiting time for an appointment, convenience of the office location, getting through to the office by phone, and length of time waiting at the office). Questions 5 to 8 asked about satisfaction with the direct encounter with the physician (time spent with the doctor, explanation of what was done for them, technical skills of the doctor, and personal manner of the doctor), and question 9 asked about overall visit satisfaction. The total nine-item score did not identify a significant difference between white and minority patients with their overall satisfaction with their visit. However, minority patients rated the quality of their interaction with the same group of physicians significantly lower than white patients when demographic factors and aspects of the visit not involving the physicians were controlled.

See "Race/ethnicity and patient satisfaction: Using the appropriate method to test for perceived differences in care," by Dr. Barr, in the Journal of General Internal Medicine 19, pp. 937-943, 2004.

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