Table 1

 Summary of factor and global satisfaction assessment studies

Author, year, and countryFactors assessedMethod of assessing factor satisfactionMethod of assessing global satisfactionMain findings
Bjorvell and Steig15 1991 SwedenPerceived levels of information on arrival100 point visual analogue scale (VAS)“How do you feel?”Increased satisfaction with respect, general treatment and staff attitude related to perceived level of initial information. p<0.05
“Would you return?”
100 point VAS scale
Booth et al31 1992 UKWaiting times4 point Likert scale and open-ended questionsN/ASatisfaction levels with components of waiting times. “Ideal” and target times derived.
Hansagi et al6 1992 SwedenMultiple patient and service factors, and triage categoryLikert scale and open-ended questions“Satisfaction with medical treatment”Triage category and age related to global satisfaction. p<0.001
“Satisfaction with general care”
Weighted 4 point scale
Lewis et al8 1992 CanadaTriage category, nursing care, physician care, environment, auxiliary staff, waiting times and information3 point Likert scale and open-ended questions“Overall satisfaction with ED visit”Separate factor satisfaction levels given. Poor correlation between global satisfaction derived from specific satisfaction ratings and global satisfaction on direct questioning. Only triage category reported as strongly correlated
Weighted 3 point scale
Maitra et al16 1992 UKWaiting times, receptionist helpful, explanations of management, information on delays, interruptions, treatment discussion with doctorModified Likert scale and open-ended question“Satisfied” or “not satisfied” with outcome of visitSatisfaction correlates with wait to see doctor (p<0.003), doctor’s explanation of management (p<0.002), total time in ED (p<0.01)
Dichotomous response
Bursch et al13 1993 USAMultiple service factorsLikert scale and open-ended questions“Overall, how satisfied with ED care?”14 service factors correlated with global satisfaction. Top five were: perceived waiting time; caring nurses; ED staff organisation; caring doctor; information given. (r  = 0.63 to 0.68)
Unspecified scale
Britten et al14 1994 UKNone specified to patients. Twelve main themes identified from interview transcriptsFrequency and emphasis in interview transcriptN/AFactors identified as important are: information; waiting time; quick pain relief; sensitivity to personal circumstances; excessive questions or examination; a pleasant environment
Thompson et al17 1995 USAPerceived waiting timeLikert scaleDescribe your experience in the ED.Perceived wait relative to expected wait correlates with overall satisfaction. p<0.001
Weighted 4 point scale.
Thompson et al18 1996 USAPerceived and actual waiting times (to see doctor and for entire visit). Explanation given of delays, and procedures. Staff attitudesOpen-ended questionsDescribe experience.Information and perceived wait (but not actual wait) correlate with global satisfaction. p<0.001
Weighted 4 and 3 point scales
Hall et al7 1996 USAMultiple demographic and service factorsLikert scale and open-ended questionsRecommendationNurse and doctor attitudes (care, courtesy, concern), and perceived wait intervals correlate with global satisfaction. No demographic factor correlated (including age)
Weighted 5 point scale
Rhee et al19 1996 USANurse and doctor technical ability. Nurse and doctor “bedside manner”. Receptionist service. Perceived wait intervals5 point Likert scaleRate overall quality (weighted 5 point scale)Patient perceptions of technical quality of care (p<0.001) and perceived waiting times (p<0.005) correlate with global satisfaction, and are more important than bedside manner
Recommendation (dichotomous)
Bruce et al32 1998 UK30 items on nursing care, environment, ancillary services and information3 point Likert scalesN/APrimary area of concern was information about length of waiting time
Yarnold et al11 1998 (two part study) USAPerceived waiting times, information and explanations, staff attitudesLikert scale“Overall satisfaction” (symmetrical 5 point scale and weighted 4 point scale)Overall satisfaction levels are almost perfectly predictable from ratings of perceived staff attitudes
Boudreaux et al12 2000 USA22 items including registration, nurse and doctor factors, waiting times, discharge instructions and estimated length of stay5 point Likert scaleRecommendationCaring staff, perception of safety, understanding discharge instructions, nurse technical skills and waiting time predict overall satisfaction. (p<0.05) Perceptions of care outweighed demographics and visit characteristics. Some differences between predictors of overall satisfaction and likelihood to recommend
Overall satisfaction
Morgan et al10 2000 UK16 varying paired combinations of doctor’s manner, waiting time, service accessibility, known doctor, consultation type, doctor’s shift.Conjoint analysis (ranking of paired preferences)N/ADoctor’s manner and waiting times are the most important factors. Patients will tolerate a doctor who seems rushed if they can be seen sooner
Sun et al5 2000 USANine sociodemographic variables, 15 comorbid conditions, 18 process of care measures. Triage score, five service factors (courtesy, completeness of care, explanation, waiting time, discharge instructions). 19 specified problems5 point Likert scale“Overall satisfaction” (5 point Likert scale)Significant process of care measures: triage status, number of treatments. Significant problems: no help when needed; poor explanation of problem cause and test results; not informed about waiting time, when to resume normal activities, or when to reattend. Significant patient factors: age and race. Willingness to return is strongly predicted by satisfaction
Willingness to return (dichotomous response)