title: The impact of health literacy, patient-centered communication and shared decision-making on patients' satisfaction with care received in German primary care practices.
abstract: Findings on the association between health literacy skills and patient-reported outcomes such as satisfaction with health care delivery are scarce. We explored the extent to which subjective health literacy skills and the perception of the application of patient-centered communication and shared decision-making are associated with patient's satisfaction with care received by their general practitioner (GP).
  
  
  
  A nationwide cross sectional survey was administered in a random sample of 1125 German adults. A binary logistic regression model controlling for demographics and health status was used to examine the independent contributions of predictor variables (i.e. subjective health literacy, shared decision-making, patient-centered communication) on satisfaction with care received by the GP.
  
  
  
  Respondents with sufficient health literacy skills were 2.06 times as likely (95 % [CI]: 1.002-4.264) and those who were involved in shared decision-making by their GP were 4.02 times as likely (95 % [CI]: 1.849-8.744) to be satisfied with care received by their GP. Respondents who experienced that their GP explained things in an easy to understand way (OR: 4.44; 95 % [CI]: 1.817-10.869), knew important things about their medical history (OR: 3.46; 95 % [CI]: 1.502-7.994) and spent enough time with them, also reported to be more satisfied (OR: 3.12; 95 % [CI]: 1.410-6.905).
  
  
  
  German adults having sufficient subjective health literacy skills and experiencing a more patient-centered relationship with their GP are more likely to be satisfied with care. These findings are important for health care organizations aiming to respond to health literacy needs of patients.
authors: Institute for Health Economics and Clinical Epidemiology, University Hospital of Cologne, Gleuelerstr. 176-178, 50935, Cologne, Germany. sibel.altin@uk-koeln.de.
authors: Sibel Vildan
authors: SV
authors: Altin
authors: Institute for Health Economics and Clinical Epidemiology, University Hospital of Cologne, Gleuelerstr. 176-178, 50935, Cologne, Germany.
authors: Stephanie
authors: S
authors: Stock
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003142:Communication; D003430:Cross-Sectional Studies; D059026:Diagnostic Self Evaluation; D005260:Female; D058005:General Practitioners; D005858:Germany; D019538:Health Care Surveys; D057220:Health Literacy; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D011320:Primary Health Care; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Health literacy; Health literate health care organization; Patient satisfaction; Patient-centered communication; Patient-reported outcomes; Primary care; Shared decision-making