What do Hong Kong adult primary care patients want from their general practitioners? Are they satisfied?

Objective. Fulfillment of patients' expectations influences satisfaction, which in tum affects treatment compliance and clinical outcome. Although there have been regular research studies on patients' expectations and satisfactions in Western countries, these concepts are relatively new in Hong Kong. This study aimed to examine the relationships between adult primary care patients' expectations, what they actually receive from the general practitioner, and their satisfactions with the consultation. Study Design. The methodology developed by William et al. was used in the Hong Kong primary health care setting. The three standardized questionnaires, namely the Patient Intentions Questionnaire (PIQ), the Expectations Met Questionnaire (EMQ), and the Medical Interview Satisfaction Scale (MISS), were translated into Chinese and tested for their reliability. Six private practice primary care physicians from various districts were asked to recruit patients. Every third adult patient over 18 years of age coming to the practice during a 7-day period was invited to participate in the study. They were asked to complete the questionnaires and take part in a follow up interview. Principle component analysis was used to determine the groupings (factors) of patient expectations. Subjects were divided into three approximately equal-sized groups according to the number of expectations met, and one-way A NOVA was carried out using the satisfaction index of MISS-21 as the independent variable. Linear regression model was also used to analyze the relationship between the different groups of expectations met and the satisfaction index. Results. Translating the English versions of the questionnaires into Chinese and then back into English did not significantly alter the meaning of the questionnaire items. Kappa statistic demonstrated that the Chinese versions of standardized questionnaires have high reliability with substantial to almost perfect agreement when they were re-administered. 350 patients were invited to participate in the study, thirteen of them declined, and fifteen questionnaires were not usable, giving a response rate of 92%. Principle component analysis revealed that "Emotional support" was considered to be the most important factor by the patients. The results also demonstrated that meeting patients' expectations is significantly associated with higher rates of satisfaction. Conclusions. This study translated and validated the Chinese versions of PIQ, EMQ, and MISS-21. The most important reported expectations were the ''Emotional support" items, and the least important were the "Information seeking and management" items. Patients with more expectations met were found to have significantly higher scores on the satisfaction index.