Burke J, Cohen M, Cook J, Weber K, Garcia P, Sha B, Hershow R; International Conference on AIDS.

Int Conf AIDS. 1998; 12: 101 (abstract no. 12442).

Cook County Hospital, Chicago, IL, USA.

OBJECTIVE: To identify sources of dissatisfaction with care among HIV+ WIHS participants in Chicago, Illinois. METHODS: The WIHS is a multi-center longitudinal study of HIV disease progression in women in the US The Chicago consortium comprises four urban medical centers including one public hospital. Data from HIV+ participants' one year follow-up visit (n = 215) are included in the analysis. Content and factor analysis identified three principal components to patient satisfaction. RESULTS: The first component measures patient perceptions of financial barriers to care and access to appointments, emergency care, prescriptions, and medical specialists. Fifty-three percent (n = 112) of respondents were satisfied with their access to care and 47% (n = 101) were dissatisfied. The second component measures patient perceptions of the quality of care received, and respondents were 72% (n = 153) satisfied and 28% (n = 60) dissatisfied. The third component rates the quality of provider-patient interactions, including doubts about providers' ability and accuracy, and perceptions that providers hurry too much, ignore patients, are impersonal, make moral judgements, and dislike the patient. Respondents were only 41% (n = 87) satisfied and were 59% (n = 126) dissatisfied with interaction quality. Patient satisfaction on these three scales differs significantly (chi-square = 19.77 (d.f. = 2), p < .001). Multivariate analysis controlling for CD4 found that care site (public hospital vs. not public hospital) was significantly associated with dissatisfaction with access to care (p = .04, O.R. = 2.02); however care site was not associated with dissatisfaction with quality of care or provider-patient interaction. Dissatisfaction with quality of care was significantly associated with the patient being employed (p = .05, O.R. = 2.39), and being depressed (p = .04, O.R. = 2.32). Depression was also significantly associated with dissatisfaction with the provider-patient interaction (p = .02, O.R. = 2.52). CONCLUSION: Results affirm the multidimensional nature of patient satisfaction with HIV care and suggest that different factors influence different dimensions of care. In additio to access and quality of care, the quality of the provider-patient interaction is an important component of patient satisfaction in this cohort, and may be the least effective. Identifying the sources of dissatisfaction, and patient and provider characteristics associated with it, could help to improve care for women with HIV/AIDS.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Biomedical Research
• Chicago
• Female
• HIV Infections
• HIV Seropositivity
• Humans
• Illinois
• Longitudinal Studies
• Patient Satisfaction
• methods

Other ID:

• 98388057

UI: 102227470

From Meeting Abstracts