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The Association between Three Different Measures of Health Status and Satisfaction among Patients with Diabetes

VA Center for Practice Management and Outcomes Research and University of Michigan School of Medicine

Dylan M. Smith

VA Center for Practice Management and Outcomes Research and University of Michigan School of Medicine

Sherrie H. Kaplan

Primary Care Outcomes Research Institute, Tufts University School of Medicine

Rodney A. Hayward

VA Center for Practice Management and Outcomes Research and University of Michigan School of Medicine

Studies suggest that health status influences patient satisfaction, but little work has examined the influence of different measures of health status on satisfaction. The authors examined whether the association between health status and satisfaction varied for different measures of health status among 2000 diabetic patients receiving care across 25 Veterans Affairs facilities. Health status was measured using (1) the diabetes-related components of the Total Illness Burden Index (DM TIBI), a measure of diabetes severity and comorbidities; (2) the Short Form 36 (SF-36) Physical Function Index (PFI10); and (3) the SF-36 general health perceptions question (SF-1). Satisfaction was measured both by a 5-item scale on satisfaction with patient-provider communication and by a single item on overall diabetes care satisfaction. In adjusted models, worse health on all three health status measures correlated with lower satisfaction, but the DM TIBI explained more of the variation in satisfaction than either the PFI10 or SF-1. Moreover, when the DM TIBI was added to the model containing PFI10, PFI10 was no longer significantly associated with satisfaction. In this diabetes population, health status appears to have a substantial impact on patient satisfaction, and this effect is considerably greater for diabetes severity than for physical functioning.

Key Words: patient satisfaction • health status • profiling

Medical Care Research and Review, Vol. 60, No. 2, 158-177 (2003)
DOI: 10.1177/1077558703060002002


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