Academic journal article New Zealand Journal of Psychology

Health & Demographic Determinants of Satisfaction with Pharmacy Services in Older Adults

Academic journal article New Zealand Journal of Psychology

Health & Demographic Determinants of Satisfaction with Pharmacy Services in Older Adults

Article excerpt

Recent studies indicate that the measurement of client/patient satisfaction with health services can provide a wealth of valuable data for health researchers (Attkisson & Greenfield, 1994). Of particular importance is the potential use of such measures to identify subgroups with differential (high or low) levels of satisfaction. Armed with this information it may be possible to identify those whose needs are not well-accommodated under the present health care system. The current study sought to ascertain which, if any, health or demographic factors are associated with differential (higher or lower) levels of satisfaction with pharmacy services among older adults. A mailed questionnaire developed specifically for the present study was utilized for data collection (N=180). Results suggest reliable relationships do exist between patient satisfaction and certain health and demographic factors, as higher overall satisfaction and satisfaction with access to pharmacy services were both found to be associated with a lower number of self-reported health problems. It is suggested that physical access to pharmacy services may be compromised by disabling health problems, particularly among those living alone. Contrary to previous New Zealand research, the current study found no reliable relationship between eligibility for health subsidies and satisfaction with financial aspects of health care.

The quality of health care services has become an issue of paramount importance in contemporary health systems. As has been noted in a recent document published by the President and Fellows of the Harvard School of Public Health:

   "The health care system is changing rapidly. Increasingly, quality
   improvement and the need for quality measurement are at the forefront of
   the national health policy agenda. Fundamental changes in the structure and
   process of health care systems are occurring in both the public and private
   sectors. A major effect of the changes has been the dramatic growth of
   interest in quality measurement." (Harvard School of Public Health, 1996).

Given the climate of rapid change currently evident in the New Zealand health arena, assessment of patient satisfaction may provide an important indication of the impact of recent changes on the quality of service delivery. An emphasis on increased quality of both policy development and service delivery to older adults was strongly recommended in the final report of the Prime Ministerial Task Force on Positive Ageing (July, 1997). It specifically draws attention to a number of generic gaps in the New Zealand Governments' Social Science research activities, including a lack of "long-term research directly involving members of the population affected by policy decisions" (p. 41).

However, it is important to understand the practical significance of such research for quality management in the health sector at large. Initially, patient satisfaction surveys were conducted for marketing purposes rather than to improve the quality of health care services. However, it is now clearly established that patient satisfaction is a prerequisite for effective health care provision, as the degree of patient co-operation in following prescribed health behaviours can be significantly moderated by satisfaction with services received (Hinton & Stout, 1993). The relationship between sub-optimal delivery of health services and low satisfaction/utilization of health services has emerged as an empirical finding in recent research (Harris, Luft, Rudy & Tierney, 1995). Furthermore, this has also been linked to increased prevalence and severity of disease symptomology.

It has been demonstrated that dissatisfaction is associated with less medication compliance, resulting in negative intermediate outcomes with serious long-term consequences. For example, recent research on hypertension has established that lower satisfaction with health service provision is associated with decreased medication compliance, increased diastolic blood pressure and, over time, renal dysfunction (Harris et. …

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