Academic journal article Iranian Journal of Public Health

What Do Patients Expect from Their Physicians?

Academic journal article Iranian Journal of Public Health

What Do Patients Expect from Their Physicians?

Article excerpt

Abstract

Background: To identify the most important expectations that patients have from their physicians.

Methods: We collected data from 199 hospitalized and 201 ambulatory patients (response rates 88% and 93% respectively). We used random sampling for selection of hospitalized patients and systematic sampling for the ambulatory ones. The questionnaire consisted of 18 different expectation items categorized in 5 domains. The participants scored each item from 1 to 9 using a VAS scale and ranked domains based on their importance. We analyzed the data using univariate and regression analyses.

Results: Among the ambulatory patients, the mean±standard error of the most important expectations was as follows: competency (8.9±0.01), courteousness (8.8±0.04), consultation in case of need (8.8±0.4), clear explanation of the disease (8.8± 0.05) and attentiveness (8.8±0.04). In hospitalized patients, the following items were the most important: competency (8.4± 0.08), courteousness (8.4±0.09), availability of physician (8.4±0.09), consultation in case of need (8.2±0.11), setting following appointments (8.2±0.1), and disease follow-up (8.2±0.09). In both groups, the most important domain of expectations was "competency and quality of care" followed by "availability" in hospitalized and "giving information and patient autonomy" among ambulatory patients.

Conclusions: Our findings are similar to what reported in the literature from other countries and cultures. In addition to physician expertise and knowledge, patients value giving information and efficient doctor-patient relationship.

Keywords: Patient expectation, Patient priority, Patient-centered care

Introduction

Medical care has experienced revolutionary changes in recent years and availability of various therapeutic options and increased knowledge of patients have led to a patient-oriented medicine with a more focused attention toward patient preferences (1, 2).

A good physician seeks a holistic view of the patient and his reasonable expectations and needs. In fact, one of the current challenges of health systems is how to respond and fulfill patients' expectations. Despite these, knowing what patients want and what matters to them are relatively ignored aspects of medical care (2-4). Knowledge of patients' priorities and using that knowledge in practice will improve quality of care and patient satisfaction (5-7). Furthermore, the physicians' interpretation of priority may be different from that of patients' (8-11) and this difference may lead to neglect of certain aspects of patient care.

All the studies focusing on patient priorities have been carried out in European or American countries (2, 5) and it is not clear if one can generalize their results to a country like Iran that has a different cultural, social and economical background (12).

This study was conducted to investigate what patients expect of their physicians in order to offer interventions to improve patient satisfaction and medical care.

Materials and Methods

Sampling

The study was carried out in an academic general hospital in Tehran, Iran on patients older than 14 yr during Jan-Feb 2007. Four hundred patients (199 hospitalized and 201 ambulatory) participated in the study. Each day we randomly selected 15 hospitalized patients from the hospital's admission list excluding patients from pediatrics, obstetrics and emergency wards. Patients were entered if they were able and willing to participate. We used a systematic sampling approach for selection of ambulatory patients so that each day we approached 15 patients with odd admission numbers at the hospital's polyclinic.

Questionnaire

The questionnaire was comprised of 18 items categorized within five domains (Table 1). We developed the questionnaire using selected previously published studies (2, 5, 10) and a pilot study of 30 patients about their expectations. …

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