title: Factors associated with changes in satisfaction with care.
abstract: OBJECTIVE
  Satisfaction with care is an important outcome for evaluating the effectiveness of medical care. Many factors can influence satisfaction, including disease state, healthcare utilization, and health-status changes. However, few studies have investigated the association between these factors and changes in satisfaction.
  
  
  METHODS
  This study examined the influence of personal characteristics, type of health plan, disease states, and healthcare utilization on changes in satisfaction with care in a prospective cohort over a 12-month period through two surveys, baseline and follow-up.
  
  
  METHODS
  Enrollees in one of three different commercial health plans: point-of-service product, an unrestricted fee-for-service product, and a preferred-provider organization product.
  
  
  RESULTS
  Two multivariate logistic regression models were constructed. The first model evaluated factors that predicted increased satisfaction with care between the two surveys. Compared with respondents who reported no change in health status, both those with improved health status (odds ratio [OR], 1.29, 95% confidence interval [CI95], 1.03-1.61) and those with declines in health (OR, 1.29, CI95, 1.03-1.61) were significantly more likely to report an increase in satisfaction with care. Those with a history of hospitalization were also more likely to report an increase in satisfaction with care (OR, 1.27, CI95, 1.01-1.59). The second multivariate logit model evaluated factors that predicted decreases in satisfaction with care from the baseline survey. Those with reported declines in health status were more likely to report decreases in satisfaction with medical care (OR, 1.43, CI95, 1.13-1.79). Neither age, gender, race, type of health plan, disease state, nor doctor's office visits were related to observed changes in satisfaction with medical care.
  
  
  CONCLUSIONS
  Changes in satisfaction with care appear to be related to changes in health status. However, the relation between these two attributes is not intuitively apparent.
authors.affiliation: School of Medicine, Virginia Commonwealth University, Richmond, USA.
authors.forename: B
authors.initials: B
authors.lastname: Newsome
authors.forename: S M
authors.initials: SM
authors.lastname: Retchin
authors.forename: M
authors.initials: M
authors.lastname: Jurgensen
authors.forename: L
authors.initials: L
authors.lastname: Rossiter
authors.forename: W
authors.initials: W
authors.lastname: Glasheen
authors.forename: L
authors.initials: L
authors.lastname: Colley
mesh_terms: D000328:Adult; D000368:Aged; D018588:Fee-for-Service Plans / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D007182:Income; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D019095:Point-of-Care Systems / Q000706:statistics & numerical data*; D011243:Preferred Provider Organizations / Q000706:statistics & numerical data*; D011446:Prospective Studies