 |
|
Visit-Specific Expectations and Patient-Centered Outcomes
A Literature Review
Jaya K. Rao, MD, MHS;
Morris Weinberger, PhD;
Kurt Kroenke, MD
Arch Fam Med. 2000;9:1148-1155.
Background Primary care patients often have certain expectations when visiting physicians, many of which may be undetected. These unmet expectations can affect outcomes such as satisfaction with care. We performed a formal literature review to examine the effect of fulfillment of patients' visit-specific expectations on their satisfaction as well as on health status and compliance.
Patients and Methods Included studies were conducted in primary care settings, systematically recruited patients, elicited previsit and/or postvisit expectations relative to specific visits, and measured patient-centered outcomes. Two reviewers abstracted information on study characteristics; types, timing, and method of expectation ascertainment; and outcomes. Disagreements were resolved by consensus.
Results Twenty-three studies were reviewed including 7 trials, 4 cohort studies, and 12 cross-sectional studies. Patients frequently expected information rather than specific physician actions, but physicians often did not accurately perceive patients' visit-specific expectations. In 19 studies that assessed postvisit patient satisfaction, a positive association between meeting patient expectations and overall satisfaction was demonstrated in 11 studies, inconclusive in 3, and not established in 5. In 2 studies assessing physician satisfaction, physicians with access to patients' expectations were more satisfied than those without access. Other outcomes (symptom or disease improvement, health status, test ordering, health care costs, psychological symptoms) were measured in only a few studies, and the results were inconclusive.
Conclusions Addressing patients' visit-specific expectations appears to affect satisfaction to a modest degree. Future studies should evaluate methods that efficiently elicit, prioritize, and provide patients' previsit expectations for physicians and should examine the longitudinal effect of expectation fulfillment on patient outcomes.
From the Center for Health Services Research in Primary Care, Durham VAMC, Durham, NC (Dr Rao); Center for Health Services Research, Roudebush VAMC (Dr Weinberger); Division of General Internal Medicine, Indiana University School of Medicine (Dr Kroenke); and Regenstrief Institute for Health Care (Drs Weinberger and Kroenke), Indianapolis, Ind.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Psychometric evaluation of an instrument to assess patient-reported 'psychosocial care by physicians': a structural equation modeling approach
Ommen et al.
Int J Qual Health Care 2009;21:190-197.
ABSTRACT
| FULL TEXT
Patient Satisfaction of Young Adults in Rural Clinics: Policy Implications for Nurse Practitioner Practice
Lemley and Marks
Policy Politics Nursing Practice 2009;10:143-152.
ABSTRACT
Unburdening the Difficult Clinical Encounter
Kroenke
Arch Intern Med 2009;169:333-334.
FULL TEXT
Patient expectations are not always the same
Delgado et al.
J. Epidemiol. Community Health 2008;62:427-434.
ABSTRACT
| FULL TEXT
Blood tests in tired elite athletes: expectations of athletes, coaches and sport science/sports medicine staff * Commentary
Fallon and Gerrard
Br. J. Sports. Med. 2007;41:41-44.
ABSTRACT
| FULL TEXT
Patient-Physician Fit: An Idea Whose Time Has Come
Krupat
Med Decis Making 2006;26:110-111.
Influence of Accompanied Encounters on Patient-Centeredness with Older Patients
Shields et al.
J Am Board Fam Med 2005;18:344-354.
ABSTRACT
| FULL TEXT
Expectations, Emotions, and Medical Decision Making: A Case Study on the Use of Amniocentesis
Browner and Preloran
Transcultural Psychiatry 2004;41:427-444.
ABSTRACT
Why We Don't Come: Patient Perceptions on No-Shows
Lacy et al.
Ann Fam Med 2004;2:541-545.
ABSTRACT
| FULL TEXT
Improving Health Care Experiences of Persons Who Are Blind or Have Low Vision: Suggestions From Focus Groups
O'Day et al.
American Journal of Medical Quality 2004;19:193-200.
ABSTRACT
What Complementary and Alternative Medicine Practitioners Say About Health and Health Care
Barrett et al.
Ann Fam Med 2004;2:253-259.
ABSTRACT
| FULL TEXT
Patient Expectations Regarding Eye Care: Focus Group Results
Dawn et al.
Arch Ophthalmol 2003;121:762-768.
ABSTRACT
| FULL TEXT
Paved With Good Intentions: Do Public Health and Human Service Providers Contribute to Racial/Ethnic Disparities in Health?
van Ryn and Fu
AJPH 2003;93:248-255.
ABSTRACT
| FULL TEXT
The PHQ-15: Validity of a New Measure for Evaluating the Severity of Somatic Symptoms
Kroenke et al.
Psychosom. Med. 2002;64:258-266.
ABSTRACT
| FULL TEXT
|
