Statistical analysis of an attitude scale to measure patient satisfaction with medical care.

Patient satisfaction with medical care is concept that is viewed as important to consider but difficult to measure. The most widely reported and most standardized measure of patient attitudes toward medical care is the scale developed by Hulka et al. The purpose of this article is first to present the results of three separate administrations of this scale and, second, to detail the statistical analysis performed using these data sets. The results of these three administrations show remarkable similarity of results, thus leading to an inference of high reliability. Through the statistical analysis of the validity of the scale, however, it is demonstrated that further work is needed before the attitude scale can be generally used. The three phases of the statistical analysis include an item analysis, a Guttman scalogram analysis and a factor analysis. The results of these three validity analyses do not support the attitude scale in its current form. The result of this work leads us to conclude that this attitude scale is not ready to be used in a community setting for predictive purposes, as has been suggested. Our results indicate that further revision and analysis are necessary before we can approach a valid as well as reliable attitude scale to measure patient satisfaction with medical care. Although this suggests the need for extensive theoretical research, the effort is clearly worthwhile, as a valid and reliable measurement of patient satisfaction will provide us with invaluable insights into the process of health care delivery.