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Do On-Site Patient Satisfaction Surveys Bias Results?

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Background: Response rates, patient sample characteristics, and patient satisfaction ratings were compared between two surveying methods: (1) surveys completed at the physician office site (on-site surveying), and (2) surveys mailed to patient homes following the encounter (mail-out/mail-back).

Methods: Surveying was completed at three physician practices within a 214-physician medical practice. Patients with physician appointments during four-hour time blocks were randomly split to receive either onsite or mail-based satisfaction surveys.

Results: Participants younger than 45 years of age provided much higher satisfaction ratings on site than they did by mail (p < .0001), and participants older than 45 years of age reported satisfaction levels consistently whether on site or by mail. Both age groups reported higher satisfaction with "people aspects" of care on site than they did by mail (p < .001).

Discussion: On-site methods may yield satisfaction results that are biased in a positive direction for younger patients and for all patients in which social desirability pressures are prominent. Therefore, organizations that rely on such information may have an inflated view of the patient's satisfaction with their care delivery experience. Secondly, because the differences in ratings are the greatest for the "people aspects" of care, if improvement efforts are prioritized on the basis of these rapid results, the wrong priorities may be set.

Document Type: Research Article

Publication date: March 1, 2005

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  • Published monthly, The Joint Commission Journal on Quality and Patient Safety is a peer-reviewed publication dedicated to providing health professionals with the information they need to promote the quality and safety of health care. The Joint Commission Journal on Quality and Patient Safety invites original manuscripts on the development, adaptation, and/or implementation of innovative thinking, strategies, and practices in improving quality and safety in health care. Case studies, program or project reports, reports of new methodologies or new applications of methodologies, research studies on the effectiveness of improvement interventions, and commentaries on issues and practices are all considered.

    David W. Baker, MD, MPH, FACP, executive vice president for the Division of Healthcare Quality Evaluation at The Joint Commission, is the inaugural editor-in-chief of The Joint Commission Journal on Quality and Patient Safety.

    Also known as Joint Commission Journal on Quality Improvement and Joint Commission Journal on Quality and Safety
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