Academic journal article The Journal of Rehabilitation

Problems and Benefits Associated with Consumer Satisfaction Evaluation at Independent Living Centers

Academic journal article The Journal of Rehabilitation

Problems and Benefits Associated with Consumer Satisfaction Evaluation at Independent Living Centers

Article excerpt

Because of the strong emphasis on consumer involvement, consumer satisfaction evaluation (CSE) is often referenced as a means to obtain independent living center (ILC) evaluation information. This form of evaluation is often used without recognition of inherent problems. The purpose of this paper is to provide a review of the state-of-the-art of consumer satisfaction evaluation for independent living centers. First, CSE dimensions are discussed, and problems and strengths are then reviewed from the literature. Finally, a discussion of future solutions and improvements is presented. Although there are some major problems associated with consumer satisfaction evaluation (CSE), it is a popular, economical evaluation concept that is valued in independent living rehabilitation. In two recent national surveys of independent living centers (ILCs), CSE emerged as a high priority component for program evaluation (Jones, Petty, Boles, & Mathews, 1986; Budde, Petty, & Nelson. 1984). In addition, the staff at the Research and Training Center on Independent Living have observed a number of ILCs who use consumer satisfaction in part or in whole to evaluate their centers. Nevertheless, many centers and agencies may not be aware of advantages and problems associated with CSE or the current state of technical development.

Dimensions of CSE

Service providers, administrators, and researchers define CSE in various ways. One way is to identify common practices across various dimensions. Lebow (1983a) focuses on both the narrow and broad boundaries of CSE. His narrow definition includes the extent to which services gratify consumers' wants - service adequacy, availability, accessibility, process, cost, and so on. The broad definition includes items that correlate with measures such as: goal attainment, premature termination, return for additional service (Lebow, p. 73).

While some variations are reported in evaluation approaches, the most common method is a "discrepancy approach", where consumers' expectations are matched to their perception of services provided (Pascoe, 1983). This approach is usually a self-report method requiring evaluation of various dimensions of a service. Common service dimensions have been defined by Pascoe and Atkisson 1983) as accessibility, availability, physical environment, information resources, interpersonal quality of patient-staff exchanges, technical skill of providers, service relevance, and outcome or effectiveness of services. These dimensions and many of their subcategories cut across most services.

However, various types of services might require unique subcomponents. A specific subcomponent for ILCS, for example, might include assessing the level of satisfaction with community options. ILCs spend a great deal of time advocating for and developing options for independent living, e.g., accessible housing, accessible transportation, funds for personal care attendants, legal rights. Results illustrating satisfaction with such options could be used to target needed options and determine commitment levels to develop those options. Another potential use is evaluating satisfaction with the decision-making process. Since consumers are the decision makers and must take responsibility for their own fives, (Budde & Bachelder, 1988) they should select the preferred options and services and use them to meet their independent living goals. Evaluation results could then be used to determine satisfaction with consumer decision making and to validate or modify the type and level of assistance ILC staff provide. Dimensions for consumer involvement in overall service delivery decisions might also be included. Evaluation results could validate or lead to improvements in the process of consumer involvement at the ILC policy level.

Although there are variations, the typical CSE approach combines discrepancy and self-report methods. Items are included on instruments from several broad areas. …

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