title: Customer satisfaction measurement in emergency medical services.
abstract: OBJECTIVE
  The annual patient volume in emergency medical services (EMS) systems is high worldwide. However, there are no comprehensive studies on customer satisfaction for EMS. The authors report how a customer satisfaction survey on EMS patients was conducted, the results, and the possible causes for dissatisfaction.
  
  
  METHODS
  Two prospective customer satisfactions surveys were conducted in an urban EMS system. Consecutive patients treated by EMS received a postal questionnaire approximately two weeks after service. Satisfaction was measured in a scale from 1 (very poor) to 5 (excellent). Neither EMS personnel nor patients were made aware prospectively that patient satisfaction would be measured.
  
  
  RESULTS
  Response rates to the surveys were 36.8% (432/1,175) in 2000 and 40.0% (464/1,150) in 2002. The mean general grades for the service were 4.6 and 4.5, respectively. Patients reported the highest degree of dissatisfaction when they were not taken to their hospital of choice, when they perceived that the paramedics were not able to meet their needs, and when paramedics did not introduce themselves or communicate directly with the patient's relatives. In high-volume calls (i.e., frequent chief complaints), the general satisfaction was highest in patients with arrhythmias, breathing difficulties, and hypoglycemia. Patients with drug overdose included the highest proportion of unsatisfied patients. None of the background variables (e.g., gender, transport decision, working shift) was statistically related to general patient satisfaction.
  
  
  CONCLUSIONS
  This study shows that customer satisfaction surveys can be successfully conducted for EMS. EMS systems should consider routinely using customer satisfaction surveys as a tool for quality measurement and improvement.
authors.affiliation: Helsinki EMS, Helsingin kaupunki, Finland. markku.kuisma@hel.fi
authors.forename: Markku
authors.initials: M
authors.lastname: Kuisma
authors.forename: Teuvo
authors.initials: T
authors.lastname: Määttä
authors.forename: Taisto
authors.initials: T
authors.lastname: Hakala
authors.forename: Tommi
authors.initials: T
authors.lastname: Sivula
authors.forename: Maria
authors.initials: M
authors.lastname: Nousila-Wiik
mesh_terms: D000328:Adult; D000368:Aged; D004631:Emergency Medical Service Communication Systems / Q000592:standards / Q000639:trends; D004632:Emergency Medical Services / Q000592:standards* / Q000639:trends; D005260:Female; D005387:Finland; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011336:Probability; D011446:Prospective Studies; D019984:Quality Indicators, Health Care; D012307:Risk Factors; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013997:Time Factors; D019037:Urban Health Services