Effect of organizational features on patient satisfaction with care in Italian multiple sclerosis centres

K Mattarozzi; E Baldin; C Zenesini; A Solari; M P Amato; M Leone; G Mancardi; V Martinelli; G Savettieri; C Solaro; M R Tola; R D'Alessandro; Agorà Study Group

doi:10.1111/ene.13263

Effect of organizational features on patient satisfaction with care in Italian multiple sclerosis centres

Eur J Neurol. 2017 Apr;24(4):631-637. doi: 10.1111/ene.13263. Epub 2017 Feb 21.

Authors

K Mattarozzi¹, E Baldin², C Zenesini², A Solari³, M P Amato⁴, M Leone⁵, G Mancardi⁶, V Martinelli⁷, G Savettieri⁸, C Solaro⁹, M R Tola¹⁰, R D'Alessandro²; Agorà Study Group

Affiliations

¹ Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
² Epidemiology and Biostatistics Service, IRCCS, Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy.
³ Neuroepidemiology Unit, Foundation IRCCS Neurological Institute C. Besta, Milan, Italy.
⁴ Department of Neurofarba, Section of Neurosciences, University of Florence, Florence, Italy.
⁵ SC Neurologia, Department of Medical Sciences, IRCCS 'Casa Sollievo della Sofferenza', San Giovanni Rotondo, Italy.
⁶ Department of Neurological Sciences and Vision, University of Genoa, Genoa, Italy.
⁷ Department of Neurology, MS Centre, San Raffaele Scientific Institute, Vit-Salute San Raffaele University, Milan, Italy.
⁸ Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy.
⁹ Neurology Unit, ASL 3 Genovese, Genoa, Italy.
¹⁰ Neurology Unit, University of Ferrara, Ferrara, Italy.

PMID: 28220581
DOI: 10.1111/ene.13263

Abstract

Background and purpose: Receiving clear, complete and up-to-date information and having a satisfying relationship with the health professional (HP) are of primary importance for MS patients. Healthcare organization plays a key role in promoting an effective relationship and communication between patients and HPs. The present study aims to explore which care organization and service characteristics provided by Italian MS centres best predict patients' satisfaction with healthcare.

Methods: Eighty-one centres and 707 patients (502 women, mean age 40.5 years, SD 10.2; mean education 12.2 years, SD 3.6; time since diagnosis 5.9 years, SD 1.5) were included in the analysis. The care organization and service provided by each centre were evaluated in comparison with the National Institute for Health and Care Excellence (NICE) guidelines on management of MS. Patients' satisfaction with care was measured using the patient self-assessed questionnaire 'Comunicazione medico-paziente nella Sclerosi Multipla, revised' section 2 (COSM-R section 2).

Results: The clinical characteristics of patients significantly affected their satisfaction. A multivariate regression model showed that higher patients' satisfaction (COSM-R score) was inversely associated with hospital size (number of patients under care) (β = -0.21, 95% confidence interval -0.35; -0.07) and directly associated with psychological interventions (β = 2.44, 95% confidence interval 0.29; 4.59).

Conclusions: Multiple sclerosis patients from larger hospitals are less satisfied with the information received and the relationship with HPs. Building an individualized relationship between patients and HPs and tailoring the communication of information improve patients' satisfaction. Such a goal is probably less likely to be accomplished in larger centres with many incoming patients. Moreover, when the centres also provide structured psychological interventions, the patients are more satisfied.

Keywords: care organization; health professional-patient relationship; multiple sclerosis; patients’ satisfaction; psychological support.

MeSH terms

Adult
Delivery of Health Care / organization & administration*
Female
Humans
Italy
Male
Middle Aged
Multiple Sclerosis / therapy*
Patient Satisfaction*
Physician-Patient Relations*
Surveys and Questionnaires