Primary care patient satisfaction segmentation.

PURPOSE: The aim of this study is to examine patient satisfaction with non-physician staff as related to patient demographics, satisfaction with physician, and intentions to recommend their physicians to others. DESIGN/METHODOLOGY/APPROACH: A survey was conducted at two internal medicine primary care clinics affiliated with a major university health system. A latent class analysis was used to detect patient subpopulations based on profiles of response for five satisfaction-with-staff indicators. FINDINGS: The response rate was 86.46 percent (479 of 554). Analyses revealed four patient subpopulation segments. Segment I (n = 241) patients uniformly indicated a high level of satisfaction across the five satisfaction-with-staff indicators. These patients tended to be older and less educated, and have lower incomes relative to patients in other segments. Patients in Segment II (n = 83) expressed satisfaction with staff caring and need accommodation, but dissatisfaction with access to their physicians. Patients in Segment III (n = 51) indicated high levels of satisfaction with access and low levels of satisfaction with staff caring and need accommodation. Segment IV (n = 104) patients uniformly expressed low levels of satisfaction across all indicators and generally were younger and more educated, as well as hadhigher incomes than other patients. ORIGINALITY/VALUE: Patients have different expectations from their non-physician staff, e.g. younger, more affluent, and educated patients expressed dissatisfaction with staff. This suggests that non-physician staff should provide extra/further responsiveness to have these patients' needs met. Generally, approaches that are differentially targeted to specific patient subgroups are likely to be more efficient and patient-oriented than undifferentiated approaches.

Understanding patient satisfaction, trust, and loyalty to primary care physicians.

The authors developed and empirically tested a model reflecting a system of interrelations among patient loyalty, trust, and satisfaction as they are related to patients' intentions to stay with a primary care physician (PCP) and recommend the doctor to other people. They used a structural equation modeling approach. The fit statistics indicate a well-fitting model: root mean square error of approximation = .022, goodness-of-fit index = .99, adjusted goodness-of-fit index = .96, and comparative fit index = 1.00. The authors found that patient trust and good interpersonal relationships with the PCP are major predictors of patient satisfaction and loyalty to the physician. Patients need to trust the PCP to be satisfied and loyal to the physician. The authors also found that patient trust, satisfaction, and loyalty are strong and significant predictors of patients' intentions to stay with the doctor and to recommend the PCP to others.