When the patient is the expert: measuring patient experience and satisfaction with care

TLDR

In 2018, reports highlighted the need to improve quality of care for universal health coverage, noting that person‑centred care—essential for dignity and better outcomes—is limited in practice by unclear, imprecise measures. The paper offers guidance to policymakers, researchers, and implementers on measuring person‑centred care, distinguishing patient experience from satisfaction and framing measurement around use, subjectivity, and validation. It proposes that person‑centred care measures enable evaluation of quality‑improvement efforts and hold health systems accountable. Designing measures to address use, subjectivity, and validation improves their usability.

Abstract

In 2018, three independent reports were published, emphasizing the need for attention to, and improvements in, quality of care to achieve effective universal health coverage. A key aspect of high quality health care and health systems is that they are person-centred, a characteristic that is at the same time intrinsically important (all individuals have the right to be treated with dignity and respect) and instrumentally important (person-centred care is associated with improved health-care utilization and health outcomes). Following calls to make 2019 a year of action, we provide guidance to policy-makers, researchers and implementers on how they can take on the task of measuring person-centred care. Theoretically, measures of person-centred care allow quality improvement efforts to be evaluated and ensure that health systems are accountable to those they aim to serve. However, in practice, the utility of these measures is limited by lack of clarity and precision in designing and by using measures for different aspects of person-centeredness. We discuss the distinction between two broad categories of measures of patient-centred care: patient experience and patient satisfaction. We frame our discussion of these measures around three key questions: (i) how will the results of this measure be used? ; (ii) how will patient subjectivity be accounted for? ; and (iii) is this measure validated or tested? By addressing these issues during the design phase, researchers will increase the usability of their measures.