title: Instruments to assess patient satisfaction after teleconsultation and triage: a systematic review.
abstract: BACKGROUND
  Patient satisfaction is crucial for the acceptance, use, and adherence to recommendations from teleconsultations regarding health care requests and triage services.
  
  
  OBJECTIVE
  Our objectives are to systematically review the literature for multidimensional instruments that measure patient satisfaction after teleconsultation and triage and to compare these for content, reliability, validity, and factor analysis.
  
  
  METHODS
  We searched Medline, the Cumulative Index to Nursing and Allied Health Literature, and PsycINFO for literature on these instruments. Two reviewers independently screened all obtained references for eligibility and extracted data from the eligible articles. The results were presented using summary tables.
  
  
  RESULTS
  We included 31 publications, describing 16 instruments in our review. The reporting on test development and psychometric characteristics was incomplete. The development process, described by ten of 16 instruments, included a review of the literature (n=7), patient or stakeholder interviews (n=5), and expert consultations (n=3). Four instruments evaluated factor structure, reliability, and validity; two of those four demonstrated low levels of reliability for some of their subscales.
  
  
  CONCLUSIONS
  A majority of instruments on patient satisfaction after teleconsultation showed methodological limitations and lack rigorous evaluation. Users should carefully reflect on the content of the questionnaires and their relevance to the application. Future research should apply more rigorously established scientific standards for instrument development and psychometric evaluation.
authors.affiliation: Swiss Center for Telemedicine Medgate, Basel, Switzerland.
authors.forename: Martina
authors.initials: M
authors.lastname: Allemann Iseli
authors.affiliation: Academy of Swiss Insurance Medicine, University of Basel, Basel, Switzerland.
authors.forename: Regina
authors.initials: R
authors.lastname: Kunz
authors.affiliation: Swiss Center for Telemedicine Medgate, Basel, Switzerland ; Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Martinistrasse, Hamburg, Germany.
authors.forename: Eva
authors.initials: E
authors.lastname: Blozik
keywords: consultation; evaluation; general practitioner; out-of-hours; patient satisfaction; psychometric; teleconsultation; teletriage; triage