Visit-specific expectations and patient-centered outcomes: A literature review

J. K. Rao, M. Weinberger, Kurt Kroenke

Research output: Contribution to journalArticle

150 Citations (Scopus)

Abstract

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. Patient 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.

Original languageEnglish (US)
Pages (from-to)1148-1155
Number of pages8
JournalArchives of Family Medicine
Volume9
Issue number10
StatePublished - 2000
Externally publishedYes

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Physicians
Health Status
Primary Health Care
Patient Satisfaction
Health Care Costs
Compliance
Consensus
Cohort Studies
Cross-Sectional Studies
Psychology

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Visit-specific expectations and patient-centered outcomes : A literature review. / Rao, J. K.; Weinberger, M.; Kroenke, Kurt.

In: Archives of Family Medicine, Vol. 9, No. 10, 2000, p. 1148-1155.

Research output: Contribution to journalArticle

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