title: Satisfaction with care: a measure of quality of care in prostate cancer patients.
abstract: BACKGROUND
  Patients' assessment of satisfaction with care, quality of care, and outcomes has become a central issue in patient-centered prostate cancer (PCa) care. We sought to analyze the association between patient-reported satisfaction with care and health-related quality of life (HRQoL) in newly diagnosed PCa patients.
  
  
  METHODS
  Prospective cohort design was used to recruit 590 newly diagnosed PCa patients from an urban academic hospital and a VA hospital. Participants completed satisfaction with care (CSQ-8) and HRQoL (SF-36 and UCLA-PCI) surveys prior to treatment and at 3, 6, 12, and 24 months' follow-up. Cross-lagged analysis was used to ascertain the causal direction between satisfaction with care and HRQoL. Propensity scores were used to adjust for potential selection bias between treatment groups. Linear mixed models were used to analyze the association between satisfaction with care, process of care (treatment), and outcomes (generic and prostate-specific HRQoL) after adjusting for covariates.
  
  
  RESULTS
  Cross-lagged correlation results are consistent with a cause-effect association between HRQoL and satisfaction with care. After controlling for clinical and demographic covariates, radical prostatectomy (RP) treatment was associated with higher satisfaction with care (odds ratio [OR], 7.9; P = 0.043). Improved generic and prostate-specific HRQoL were associated with higher satisfaction with care, after adjusting for demographic and clinical covariates.
  
  
  CONCLUSIONS
  Satisfaction with care appears to be associated with process of care and outcomes of care. Assessment of satisfaction with care is useful for evaluating the quality of PCa care. Satisfaction with care is an important arena in cancer outcomes research, whose full potential remains unexploited.
authors.affiliation: Department of Medicine, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA 19104-2676, USA. jravi@mail.med.upenn.edu
authors.forename: Ravishankar
authors.initials: R
authors.lastname: Jayadevappa
authors.forename: J Sanford
authors.initials: JS
authors.lastname: Schwartz
authors.forename: Sumedha
authors.initials: S
authors.lastname: Chhatre
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Wein
authors.forename: S Bruce
authors.initials: SB
authors.lastname: Malkowicz
mesh_terms: D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000628:therapy*; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care; D011788:Quality of Life