JAMA & ARCHIVES
Arch Fam Med
SEARCH
GO TO ADVANCED SEARCH
HOME  PAST ISSUES  TOPIC COLLECTIONS  CME  PHYSICIAN JOBS  CONTACT US  HELP
Institution: STANFORD Univ Med Center  | My Account | E-mail Alerts | Access Rights | Sign In
  Vol. 9 No. 10, November 2000 TABLE OF CONTENTS
  Archives
  •  Online Features
  Clinical Review
 This Article
 •Full text
 •PDF
 •Send to a friend
 • Save in My Folder
 •Save to citation manager
 •Permissions
 Citing Articles
 •Citation map
 •Citing articles on HighWire
 •Citing articles on Web of Science (35)
 •Contact me when this article is cited
 Related Content
 •Similar articles in this journal
 Topic Collections
 •Review
 •Alert me on articles by topic

Visit-Specific Expectations and Patient-Centered Outcomes

A Literature Review

Jaya K. Rao, MD, MHS; Morris Weinberger, PhD; Kurt Kroenke, MD

Arch Fam Med. 2000;9:1148-1155.

Background  Primary care patients often have certain expectations when visiting physicians, many of which may be undetected. These unmet expectations can affect outcomes such as satisfaction with care. We performed a formal literature review to examine the effect of fulfillment of patients' visit-specific expectations on their satisfaction as well as on health status and compliance.

Patients and Methods  Included studies were conducted in primary care settings, systematically recruited patients, elicited previsit and/or postvisit expectations relative to specific visits, and measured patient-centered outcomes. Two reviewers abstracted information on study characteristics; types, timing, and method of expectation ascertainment; and outcomes. Disagreements were resolved by consensus.

Results  Twenty-three studies were reviewed including 7 trials, 4 cohort studies, and 12 cross-sectional studies. Patients frequently expected information rather than specific physician actions, but physicians often did not accurately perceive patients' visit-specific expectations. In 19 studies that assessed postvisit patient satisfaction, a positive association between meeting patient expectations and overall satisfaction was demonstrated in 11 studies, inconclusive in 3, and not established in 5. In 2 studies assessing physician satisfaction, physicians with access to patients' expectations were more satisfied than those without access. Other outcomes (symptom or disease improvement, health status, test ordering, health care costs, psychological symptoms) were measured in only a few studies, and the results were inconclusive.

Conclusions  Addressing patients' visit-specific expectations appears to affect satisfaction to a modest degree. Future studies should evaluate methods that efficiently elicit, prioritize, and provide patients' previsit expectations for physicians and should examine the longitudinal effect of expectation fulfillment on patient outcomes.


From the Center for Health Services Research in Primary Care, Durham VAMC, Durham, NC (Dr Rao); Center for Health Services Research, Roudebush VAMC (Dr Weinberger); Division of General Internal Medicine, Indiana University School of Medicine (Dr Kroenke); and Regenstrief Institute for Health Care (Drs Weinberger and Kroenke), Indianapolis, Ind.



THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Psychometric evaluation of an instrument to assess patient-reported 'psychosocial care by physicians': a structural equation modeling approach
Ommen et al.
Int J Qual Health Care 2009;21:190-197.
ABSTRACT | FULL TEXT  

Patient Satisfaction of Young Adults in Rural Clinics: Policy Implications for Nurse Practitioner Practice
Lemley and Marks
Policy Politics Nursing Practice 2009;10:143-152.
ABSTRACT  

Unburdening the Difficult Clinical Encounter
Kroenke
Arch Intern Med 2009;169:333-334.
FULL TEXT  

Patient expectations are not always the same
Delgado et al.
J. Epidemiol. Community Health 2008;62:427-434.
ABSTRACT | FULL TEXT  

Blood tests in tired elite athletes: expectations of athletes, coaches and sport science/sports medicine staff * Commentary
Fallon and Gerrard
Br. J. Sports. Med. 2007;41:41-44.
ABSTRACT | FULL TEXT  

Patient-Physician Fit: An Idea Whose Time Has Come
Krupat
Med Decis Making 2006;26:110-111.
 

Influence of Accompanied Encounters on Patient-Centeredness with Older Patients
Shields et al.
J Am Board Fam Med 2005;18:344-354.
ABSTRACT | FULL TEXT  

Expectations, Emotions, and Medical Decision Making: A Case Study on the Use of Amniocentesis
Browner and Preloran
Transcultural Psychiatry 2004;41:427-444.
ABSTRACT  

Why We Don't Come: Patient Perceptions on No-Shows
Lacy et al.
Ann Fam Med 2004;2:541-545.
ABSTRACT | FULL TEXT  

Improving Health Care Experiences of Persons Who Are Blind or Have Low Vision: Suggestions From Focus Groups
O'Day et al.
American Journal of Medical Quality 2004;19:193-200.
ABSTRACT  

What Complementary and Alternative Medicine Practitioners Say About Health and Health Care
Barrett et al.
Ann Fam Med 2004;2:253-259.
ABSTRACT | FULL TEXT  

Patient Expectations Regarding Eye Care: Focus Group Results
Dawn et al.
Arch Ophthalmol 2003;121:762-768.
ABSTRACT | FULL TEXT  

Paved With Good Intentions: Do Public Health and Human Service Providers Contribute to Racial/Ethnic Disparities in Health?
van Ryn and Fu
AJPH 2003;93:248-255.
ABSTRACT | FULL TEXT  

The PHQ-15: Validity of a New Measure for Evaluating the Severity of Somatic Symptoms
Kroenke et al.
Psychosom. Med. 2002;64:258-266.
ABSTRACT | FULL TEXT  




HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | PHYSICIAN JOBS | HELP
CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP
 
© 2000 American Medical Association. All Rights Reserved.