The effect of patients' met expectations on consultation outcomes. A study with family medicine residents.
OBJECTIVE
To know the patients' expectations and the fulfillment of these at family medicine consultations by resident doctors and to assess their effect on some consultation outcomes.


METHODS
A prospective cohort study.


METHODS
Patients attending family medicine consultations held by 38 resident doctors: 1,301 eligible patients, 702 filled in all questionnaires.


METHODS
Before each visit, the patients' expectations about that particular consultation were registered. Right after the visit was over, their perception of several aspects of the communicative interaction with the doctor was measured. Later, patients were interviewed on the phone to know how their expectations had been fulfilled, how satisfied they were about the consultation, how they had followed the doctor's suggestions, if they were going to seek further care for the same cause later, and the evolution of their clinical problem. Logistic regression was the main analysis used.


RESULTS
The most common expectations were the doctor showing interest and listening (30.5%), getting some information about the diagnosis (16.3%), and sharing problems and doubts (11.1%). The rate of main expectations that were met was 76.5%. Satisfaction with the encounter was associated with the clinical evolution [odds ratio (OR) 2.23; confidence interval (CI): 1.32-3.75], and the fulfilling of the patients' main or two main expectations was significantly related to all the measured outcomes (satisfaction OR 3.51, CI: 1.73-7.8; adherence OR 1.80, CI: 1.11-2.92; clinical evolution OR 1.54, CI: 1.01-2.35; and seeking further care later OR 0.54, CI:0.36-0.81)


CONCLUSIONS
Patients prioritize expectations of a more general sort when they attend primary care consultations and residents fulfill these acceptably. The fulfillment of expectations seems to affect the studied outcomes more than other factors.
Ruiz-Moral
Roger
R
Córdoba Teaching Unit of Family Medicine, Andalusia Health Service, COGRAMA Group: Spanish Primary Care Research Network (redIAPP), Córdoba, Spain. roger.ruiz.sspa@juntadeandalucia.es
Pérula de Torres
Luis Angel
LA
Jaramillo-Martin
Inmaculada
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005194:Family Practice / Q000193:education*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011446:Prospective Studies; D013030:Spain; D011795:Surveys and Questionnaires