Patient satisfaction and change in medical care provider : a longitudinal study

Longitudinal data from RAND's Health Insurance Experiment were used to test the hypothesis that provider continuity can be modeled as one behavioral consequence of patient satisfaction. Bivariate and multivariate analysis (controlling for sociodemographic characteristics, prior use of services, health status, and health insurance plan) support the hypotheses. A multivariate linear probability function indicated that a one-point decrease on a general satisfaction scale was associated with a 3.4-percentage-point increase in the probability of provider change. The relationship between satisfaction scores and continuity during the following year appears to be roughly linear; no "threshold" satisfaction level at which the probability of provider change increased markedly was observed. The authors discuss needed improvements in the measurement of provider continuity and the need for further study of other behavioral consequences of patient satisfaction.