A longitudinal analysis of the relationship between self-rated health and patient satisfaction with service quality in a large cohort of cancer patients
METHODS : 1,669 cancer patients treated at four Cancer Treatment Centers of America® hospitals completed a patient satisfaction survey on 4 distinct occasions (at least 2 months apart) between July 2011 and March 2013. Self-rated health was measured on a 7-point scale (“very poor” to “excellent”). Patient satisfaction was also measured on a 7-point scale (“completely dissatisfied” to “completely satisfied”). Spearman correlation was used to investigate the association between them. Logistic Generalized Estimating Equations (GEE) was used to evaluate the longitudinal impact of self-rated health on patient satisfaction after controlling for covariates.
RESULTS : Mean age was 55.6 years. 606 were males and 1,063 females. Most common cancer types were breast (29.7%), colorectal (11.2%), lung (10.9%) and prostate (10.8%). 595 patients had early-stage (I-II) disease and 906 had late-stage (III-IV) disease. Proportion of patients “completely satisfied” with their care at 4 time points was 84.2%, 84.0%, 84.7% and 82.6%. Correlation coefficients between self-rated health and patient satisfaction at 4 time points were 0.20, 0.17, 0.15 and 0.18 (p<0.001 for all). Upon multivariate logistic GEE analysis, “excellent” health status was associated with a 2.3 times greater odds (95% CI: 1.9–2.8) of being “completely satisfied” after controlling for time, age, gender, treatment history, tumor stage and hospital location.
CONCLUSIONS : Self-rated health is a weak but statistically significant predictor of patient satisfaction with service quality. Self-rated health cannot be ignored when evaluating the predictors of patient satisfaction and should be used as a stratification variable when comparing patient satisfaction across different groups or institutions.