Factors associated with patient satisfaction with health care among Polish older people: results from the polish part of the COURAGE in Europe

Objectives: The growing number of chronic conditions and functional limitations resulting from demographic changes and the aging of the population poses several challenges for health care and public health. Consequently, it plays a role in the assessment of the impact of diagnostic and treatment effects on patient satisfaction. The study aims to assess older patients' overall satisfaction with the medical care and healthcare system in Poland and to verify such factors as patient-doctor interactions, access to health care and other sociodemographic characteristics as possible determinants of patient satisfaction at the later stage of life.

Methods: The survey data represent the polish part of the cross-sectional COURAGE in Europe study. Satisfaction with hospital care, outpatient care, and the healthcare system in Poland was assessed. The indices for the psychosocial dimension of the patient-doctor relationships and access to hospital/outpatient care were developed based on patients' experiences as the possibility of talking about private matters, the clarity of explanations, the involvement in decision-making process, being treated respectfully, the duration of waiting and the ease of access to a preferred doctor or other healthcare professional. The ordered probit regression models were used.

Results: The psychosocial dimension of patient-doctor relationships was associated with the satisfaction with both hospital and outpatient care. Being treated with respect (very good experience vs. bad odds ratio [OR] = 8.1, 95% confidence interval [CI]: [1.9, 34.4]) and the possibility to talk about private matters with medical team (very good experience vs. bad OR = 3.5, 95% CI: [1.1, 10.4]) during the last stay in hospital were reflected in the higher satisfaction with the healthcare system. By contrast, the involvement of patients in the decision-making process (very good experience vs. bad OR = 3.6, 95% CI: [1.8, 6.7]) or access to outpatient health care (based on developed index OR = 1.02, 95% CI: [1.01, 1.02]) were found to be significant determinants of satisfaction with the healthcare system in Poland. Other factors associated with satisfaction with hospital stay were gender and changes in health conditions, whereas achieving the expected outcome was related to satisfaction with outpatient care, and the expenditure for medicines and medical services - to satisfaction with the heathcare system.

Conclusion: The investigation confirms an important role of doctor-patient communication skills in improving older patient satisfaction and highlights the need for identifying the psychosocial dimension of patient-doctor relationships as an important part of health care.