Patients' satisfaction with care after stroke: relation with characteristics of patients and care.
OBJECTIVE
To evaluate stroke patients' satisfaction with care received and to identify characteristics of patients and care which are associated with patients' dissatisfaction.


METHODS
Cross sectional study.


METHODS
Sample of patients who participated in a multicentre study on quality of care in 23 hospitals in the Netherlands.


METHODS
327 non-institutionalised patients who had been in hospital six months before because of stroke.


METHODS
Data were collected on (a) characteristics of patients: socio-demographic status, cognitive function (mini mental state examination), disability (Barthel index), handicap (Rankin scale), emotional distress (emotional behavior subscale of the sickness impact profile) and health perception; (b) characteristics of care: use of various types of formal care after stroke, unmet care demands perceived by patients, unmet care demands confirmed by their general practitioners, continuity of care, and secondary prevention, and (c) patients' satisfaction with care received.


RESULTS
40% of the study sample were dissatisfied with at least one type of care received. Multivariate analyses showed that unmet care demands perceived by patients (odds ratio (OR) 3.2, 95% confidence interval (95% CI) 1.8-5.7) and emotional distress (OR 1.8, 95% CI 1.1-3.0) were the main variable associated with dissatisfaction.


CONCLUSIONS
Patients' satisfaction was primarily associated with emotional distress and unmet care demands perceived by patients. No association was found between patients' satisfaction on the one hand and continuity of care or secondary prevention on the other; two care characteristics that are broadly accepted by professional care givers as important indicators of quality of long term care after stroke.


CONCLUSIONS
In view of these findings discussion should take place about the relative weight that should be given to patients' satisfaction as an indicator of quality of care, compared with other quality indicators such as continuity of care and technical competence. More research is needed to find which dimensions of quality care are considered the most important by stroke patients and professional care givers.
Scholte op Reimer
W J
WJ
Academic Medical Center, University of Amsterdam, Netherlands.
de Haan
R J
RJ
Limburg
M
M
van den Bos
G A
GA
D002561:Cerebrovascular Disorders / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy*; D003266:Continuity of Patient Care / Q000592:standards; D003430:Cross-Sectional Studies; D006801:Humans; D008134:Long-Term Care / Q000592:standards; D017060:Patient Satisfaction; D011361:Professional Competence; D011787:Quality of Health Care; D012008:Recurrence; D006113:United Kingdom