Patient satisfaction with emergency house calls.

STUDY OBJECTIVES: To identify determinants of patient satisfaction with emergency house calls and to assess the properties of a satisfaction measurement questionnaire. DESIGN: Patient survey, combined with routinely collected information on the circumstances of the house call. SETTING: Emergency house calls provided by an independent emergency care organization (ECO) in Geneva, Switzerland. PARTICIPANTS: Consecutive sample of 389 patients (67% response rate). MAIN OUTCOME MEASURE: Patient satisfaction. PREDICTOR VARIABLES: patient age and sex, type of medical problem, time of visit, waiting time, duration of visit, perceived effectiveness of treatment. RESULTS: The satisfaction questionnaire was easy to administer. Factor analysis identified 3 separate dimensions of satisfaction, which pertained to the visit itself, to access and to general attitude toward the ECO. Validation tests were consistent with expectations. In multivariate analysis, older patient age and greater perceived treatment effectiveness predicted independently all satisfaction scales. Presence of a mixed physical and mental problem reduced satisfaction with the visit itself only, a delay between the phone call and the visit exceeding one hour reduced satisfaction with access and worsened the attitude toward the ECO. CONCLUSION: The instrument used to measure patient satisfaction with emergency house calls performed well. Overall levels of satisfaction were high. Perceived effectiveness of treatment was the strongest correlate of patient satisfaction. Monitoring of patient satisfaction in emergency settings may contribute to improvements of quality of care.

Overlap syndrome with multiple calcifications of the spleen.

A woman with overlapping features of rheumatoid arthritis and systemic lupus erythematosus presented with multiple small asymptomatic calcifications of the spleen. The absence of any other origin suggests that these calcifications are directly related to the connective tissue disease.