Is patient satisfaction and perceived service quality with musculoskeletal rehabilitation determined by patient experiences?

OBJECTIVE: To assess the relationships between patient experiences and two overall evaluations - satisfaction and service quality - in outpatient rehabilitation settings.
DESIGN: A cross-sectional, self-reported survey carried out in the year 2009.
SETTING: Three outpatient rehabilitation units belonging to Spanish hospitals located in Barcelona, Madrid and Seville.
SUBJECTS: Four hundred and sixty-five outpatients (response rate 90%) mean age 39.4 (SD = 11.9) years. MAIN MEASURES: Self-reported experiences on aspects of care, participants' perception of service quality, satisfaction with care, socio-demographic and health characteristics.
RESULTS: Satisfaction and service quality were highly correlated (rho = 0.72, P< 0.001). Two multivariate logistic regression models using satisfaction and service quality (with adjusted R(2) 31.5% and 37.1%, respectively) indicated that patients' experiences and global rating of health improvement have more effect on those evaluations than socio-demographic characteristics. Mean satisfaction was 8.9 (SD = 1.2), and 88% of respondents described high service quality. However, nearly 25% of the respondents who reported high-quality evaluations also indicated a problem score of more than 50% in almost all aspects of care studied.
CONCLUSIONS: Satisfaction and service quality provide a poor indicator of patients' experiences. Both are two proxies but distinct constructs in rehabilitation care. Besides, not all problems encountered by patients are equally important to them.