• Vol. 38 No. 6, 487–493
  • 15 June 2009

Effects of Survey Mode on Results of a Patient Satisfaction Survey at the Observation Unit of an Acute Care Hospital in Singapore



Introduction: Over the years, surveys have become powerful tools for assessing a wide range of outcomes among patients. Healthcare managers and professionals now consider patient satisfaction as an outcome by itself. This study aims to determine if results of a patient satisfaction survey are affected by the manner by which the survey instrument is administered. Materials and Methods: A patient satisfaction survey was conducted from May 2006 to October 2007 in a tertiary level acute care facility. All patients admitted to the observation unit during the study period were invited to participate. Using a contextualised version of the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Hospital Survey, data was collected through either a phone interview, face to face interview or self-administered questionnaire. Each of these survey modes was administered during 3 different phases within the study period. Results: Eight hundred thirty-two (832) patients were included in the survey. Based on results of univariate analysis, out of the 18 questions, responses to 11 (61.1%) were related to survey mode. Face-toface interview resulted in the greatest proportion of socially desirable responses (72.7%), while phone interview yielded the highest proportion of socially undesirable responses (63.3%). After controlling for possible confounders, logistic regression results showed that responses to 55.6% of the questions were affected by survey mode. Variations in response between phone interview and self-administered questionnaire accounted for 87.5% of the observed differences. Conclusions: Researchers must be aware that the choice of survey method has serious implications on results of patient satisfaction surveys.

Surveys are tools originally built around the social sciences, and which have found their way to the health disciplines. Medical specialties have explored the value of surveys for evaluating diseases. Questionnaires have been developed as aids for managing conditions such as asthma, headache and other chronic respiratory diseases.1-3 Another domain within healthcare where surveys are increasingly being used is health services research (HSR). The US Institute of Medicine defines HSR as “a multi-disciplinary field of inquiry, both basic and applied, that examines the use, costs, quality, accessibility, delivery, organisation, financing, and outcomes of health care services to increase knowledge and understanding of the structure, processes, and effects of health services for individuals and populations.”4 As HSR investigates patients’ “preferences for and expectations of health services,”5 there is a need to obtain feedback about patients’ perceived state of health and experience with care.

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