Measuring the Patient Experience in Primary Care: Comparing E-mail and Waiting Room Survey Delivery in a Family Health Team

Overview

Journal Can Fam Physician

Specialties General Medicine
Public Health

Date 2016 Dec 15

PMID 27965350

Citations 14

Authors

Morgan Slater

Tara Kiran

Affiliations

Soon will be listed here.

Abstract

Objective: To compare the characteristics and responses of patients completing a patient experience survey accessed online after e-mail notification or delivered in the waiting room using tablet computers.

Design: Cross-sectional comparison of 2 methods of delivering a patient experience survey.

Setting: A large family health team in Toronto, Ont.

Participants: Family practice patients aged 18 or older who completed an e-mail survey between January and June 2014 (N = 587) or who completed the survey in the waiting room in July and August 2014 (N = 592).

Main Outcome Measures: Comparison of respondent demographic characteristics and responses to questions related to access and patient-centredness.

Results: Patients responding to the e-mail survey were more likely to live in higher-income neighbourhoods (P = .0002), be between the ages of 35 and 64 (P = .0147), and be female (P = .0434) compared with those responding to the waiting room survey; there were no significant differences related to self-rated health. The differences in neighbourhood income were noted despite minimal differences between patients with and without e-mail addresses included in their medical records. There were few differences in responses to the survey questions between the 2 survey methods and any differences were explained by the underlying differences in patient demographic characteristics.

Conclusion: Our findings suggest that respondent demographic characteristics might differ depending on the method of survey delivery, and these differences might affect survey responses. Methods of delivering patient experience surveys that require electronic literacy might underrepresent patients living in low-income neighbourhoods. Practices should consider evaluating for nonresponse bias and adjusting for patient demographic characteristics when interpreting survey results. Further research is needed to understand how primary care practices can optimize electronic survey delivery methods to survey a representative sample of patients.

Citing Articles

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Shah N, Latifovic L, Meaney C, Moineddin R, Derocher M, Alhaj M JAMA Netw Open. 2022; 5(12):e2246397.

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Stahl K, Groene O PLoS One. 2021; 16(12):e0259252.

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References

Cleary P . The increasing importance of patient surveys. Qual Health Care. 2000; 8(4):212. PMC: 2483664. DOI: 10.1136/qshc.8.4.212. View

Brodie M, Flournoy R, Altman D, Blendon R, Benson J, Rosenbaum M . Health information, the Internet, and the digital divide. Health Aff (Millwood). 2001; 19(6):255-65. DOI: 10.1377/hlthaff.19.6.255. View

Powers T, Swan J . Time does not heal all wounds. Patients report lower satisfaction levels as time goes by. Mark Health Serv. 2001; 21(3):10-4. View

Miller E, Neal D, Roberts L, Baer J, Cressler S, Metrik J . Test-retest reliability of alcohol measures: is there a difference between internet-based assessment and traditional methods?. Psychol Addict Behav. 2002; 16(1):56-63. View

Urden L . Patient satisfaction measurement: current issues and implications. Lippincotts Case Manag. 2002; 7(5):194-200. DOI: 10.1097/00129234-200209000-00006. View

Bowman M, Herndon A, Sharp P, Dignan M . Assessment of the patient-doctor interaction scale for measuring patient satisfaction. Patient Educ Couns. 1992; 19(1):75-80. DOI: 10.1016/0738-3991(92)90103-p. View

Gribble R, Haupt C . Quantitative and qualitative differences between handout and mailed patient satisfaction surveys. Med Care. 2005; 43(3):276-81. DOI: 10.1097/00005650-200503000-00010. View

Bowling A . Mode of questionnaire administration can have serious effects on data quality. J Public Health (Oxf). 2005; 27(3):281-91. DOI: 10.1093/pubmed/fdi031. View

McCabe S, Couper M, Cranford J, Boyd C . Comparison of Web and mail surveys for studying secondary consequences associated with substance use: evidence for minimal mode effects. Addict Behav. 2005; 31(1):162-8. DOI: 10.1016/j.addbeh.2005.04.018. View

10.

Stevens M, Reininga I, Boss N, van Horn J . Patient satisfaction at and after discharge. Effect of a time lag. Patient Educ Couns. 2005; 60(2):241-5. DOI: 10.1016/j.pec.2005.01.011. View

11.

de Vries H, Elliott M, Hepner K, Keller S, Hays R . Equivalence of mail and telephone responses to the CAHPS Hospital Survey. Health Serv Res. 2005; 40(6 Pt 2):2120-39. PMC: 1361249. DOI: 10.1111/j.1475-6773.2005.00479.x. View

12.

Cheung Y, Goh C, Thumboo J, Khoo K, Wee J . Quality of life scores differed according to mode of administration in a review of three major oncology questionnaires. J Clin Epidemiol. 2006; 59(2):185-91. DOI: 10.1016/j.jclinepi.2005.06.011. View

13.

Evans R, Edwards A, Evans S, Elwyn B, Elwyn G . Assessing the practising physician using patient surveys: a systematic review of instruments and feedback methods. Fam Pract. 2007; 24(2):117-27. DOI: 10.1093/fampra/cml072. View

14.

Beebe T, Richard Locke 3rd G, Barnes S, Davern M, Anderson K . Mixing web and mail methods in a survey of physicians. Health Serv Res. 2007; 42(3 Pt 1):1219-34. PMC: 1955260. DOI: 10.1111/j.1475-6773.2006.00652.x. View

15.

Buskirk T, Stein K . Telephone vs. mail survey gives different SF-36 quality-of-life scores among cancer survivors. J Clin Epidemiol. 2008; 61(10):1049-55. DOI: 10.1016/j.jclinepi.2007.11.012. View

16.

Elliott M, Zaslavsky A, Goldstein E, Lehrman W, Hambarsoomians K, Beckett M . Effects of survey mode, patient mix, and nonresponse on CAHPS hospital survey scores. Health Serv Res. 2009; 44(2 Pt 1):501-18. PMC: 2677051. DOI: 10.1111/j.1475-6773.2008.00914.x. View

17.

Lemos P, Pinto A, Morais G, Pereira J, Loureiro R, Teixeira S . Patient satisfaction following day surgery. J Clin Anesth. 2009; 21(3):200-5. DOI: 10.1016/j.jclinane.2008.08.016. View

18.

Jensen H, Ammentorp J, Kofoed P . User satisfaction is influenced by the interval between a health care service and the assessment of the service. Soc Sci Med. 2010; 70(12):1882-1887. DOI: 10.1016/j.socscimed.2010.02.035. View

19.

Jensen H, Ammentorp J, Kofoed P . Assessment of health care by children and adolescents depends on when they respond to the questionnaire. Int J Qual Health Care. 2010; 22(4):259-65. DOI: 10.1093/intqhc/mzq021. View

20.

Browne K, Roseman D, Shaller D, Edgman-Levitan S . Analysis & commentary. Measuring patient experience as a strategy for improving primary care. Health Aff (Millwood). 2010; 29(5):921-5. DOI: 10.1377/hlthaff.2010.0238. View