Will patient satisfaction set the preventive services implementation agenda?

BACKGROUND: Patient satisfaction has become a measure of the quality of health care, and in highly competitive markets like the Twin Cities metropolitan area of Minnesota, it has become a health plan marketing tool. The purpose of this analysis is to examine whether the known association between preventive services and patient satisfaction might spontaneously lead clinicians to recommend preventive services at greater rates. DESIGN: We conducted a mail survey of a stratified random sample (n = 6,830) of adult patients who had recently visited a physician in one of 44 clinics in and around Minneapolis-St. Paul, Minnesota. The main outcome measures are patient-reported rates of being advised to have eight preventive services, patient satisfaction with preventive services, patient satisfaction with overall health care, and correlations among these variables. RESULTS: Self-reports of being advised to have a preventive service when due were correlated with higher levels of satisfaction with that specific service only at levels of r = 0.16 to r = 0.35. They were correlated at levels of r = 0.01 to r = 0.27 with the Group Health Association of America satisfaction index. CONCLUSIONS: Although there is a positive association between being advised to have a preventive service on the one hand and reporting satisfaction with care on the other, this association appears too weak to spontaneously stimulate physicians to recommend preventive services to their patients. This suggests that, if preventive services are to be delivered at higher rates, they must become an explicit component of quality evaluations.