A follow-up comparison of patient satisfaction among prepaid and fee-for-service patients.

This study reports the results of a follow-up patient satisfaction survey that sampled patients enrolled in a capitation program and compared their satisfaction levels with otherwise similar patients in a fee-for-service program two years after the programs began. On a scale of 1 (very dissatisfied) to 5 (very satisfied), the mean general satisfaction level for 158 prepaid patients was 3.17 +/- 0.70, and 3.42 +/- 0.61 for 87 fee-for-service patients (P less than .05). This finding contrasts with no differences seen in a previous study of the same populations at six months after the programs began (mean general satisfaction levels of 3.26 and 3.36 for the prepaid and fee-for-service patients, respectively). A statistically significant difference also existed in the subdimension "technical aspects of quality of care": 3.38 +/- 0.65 for prepaid patients, and 3.61 +/- 0.53 for fee-for-service service patients (P less than .05). Levels of satisfaction within other individual constructs were similar for both groups and tended to remain the same over two years, although satisfaction with access to care decreased among prepaid patients, and satisfaction with continuity of care increased among fee-for-service patients. These data support the hypothesis that overall satisfaction levels and certain aspects of patient satisfaction may be compromised by a capitation program.