The factor analytic development and validation of numerous index scores to measure patient attitudes regarding characteristics of doctors and medical care services are described. Index scores meeting factor analytic criteria and found to be reliable were used to study the nature and number of attitudinal dimensions underlying patient satisfaction. Use of index scores that have met logical and empirical criteria is in contrast to the common practice of using individual questionnaire items as the unit of analysis. Four major dimensions of patient attitudes are identified and described, including attitudes toward a doctor's conduct (humanness and quality), availability of services, continuity/convenience of care and access mechanisms, cost, payment mechanisms and ease of emergency care. Measures of attitudes toward caring (humanness) and curing (quality/competence) aspects of doctor conduct appear to primarily reflect the same underlying attitudinal dimension.
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