title: Organizational determinants of patient-centered fertility care: a multilevel analysis.
abstract: OBJECTIVE
  To identify organizational determinants of positive patient experiences with fertility care, with the goal of improving patient centeredness of care.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  One large university clinic and 12 medium-sized fertility clinics in the Netherlands.
  
  
  METHODS
  Three hundred and sixty-nine couples receiving medically assisted reproduction in one of the participating clinics between March and May 2008.
  
  
  METHODS
  None.
  
  
  METHODS
  Organizational determinants of patients' experiences with patient centeredness in fertility care.
  
  
  RESULTS
  Of the patients during the relevant period, 78% of the women and 76% of their partners participated in the study. Infertile couples who have a lead physician, have access to an electronic personal health record, or see trained fertility nurses have more positive experiences with aspects of patient-centered care, like continuity of care and partner involvement. Moreover, receiving a treatment other than in vitro fertilization was negatively associated with the perceived patient centeredness of care. The identified determinants explained 5.1% to 22.4% of the total variance.
  
  
  CONCLUSIONS
  This study provides organizational determinants of patients' experiences with fertility care on numerous facets of patient centeredness. These organizational determinants can be used as valuable tools to enable clinics to provide a more positive patient experience.
authors.affiliation: Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands. i.vanempel@obgyn.umcn.nl
authors.forename: Inge W H
authors.initials: IW
authors.lastname: van Empel
authors.forename: Rosella P M G
authors.initials: RP
authors.lastname: Hermens
authors.forename: Reinier P
authors.initials: RP
authors.lastname: Akkermans
authors.forename: Kees W P
authors.initials: KW
authors.lastname: Hollander
authors.forename: Willianne L D M
authors.initials: WL
authors.lastname: Nelen
authors.forename: Jan A M
authors.initials: JA
authors.lastname: Kremer
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005298:Fertility / Q000502:physiology; D006801:Humans; D007246:Infertility / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D055361:Multilevel Analysis; D009426:Netherlands; D017060:Patient Satisfaction; D018802:Patient-Centered Care / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D027724:Reproductive Techniques, Assisted / Q000592:standards / Q000706:statistics & numerical data; D055815:Young Adult