Volume 44 Number 2 2007
Pages 143 — 152

Abstract - Effects of depression and pain severity on satisfaction in medical outpatients: Analysis of the Medical Outcomes Study

Matthew J. Bair, MD, MS;1-2* Kurt Kroenke, MD;1-2 Jason M. Sutherland, PhD;1-2 Kimberly D. McCoy, MS;1 Hillary Harris, MS;3 Colleen A. McHorney, PhD4

1Health Services Research and Development Center of Excellence on Implementing Evidence-Based Practice, Richard L. Roudebush Department of Veterans Affairs Medical Center, Indianapolis, IN; 2Indiana University Center for Health Services and Outcomes Research, Regenstrief Institute, Inc, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN; 3RTI International, Research Triangle Park, NC; 4Merck & Company Inc, West Point, PA

Abstract — Patient satisfaction has been used as a healthcare quality indicator. We examined how depression and pain severity affected satisfaction in medical outpatients. Data from the Medical Outcomes Study were analyzed. The primary outcomes were seven satisfaction domains from the Patient Satisfaction Questionnaire. Depression was identified through a clinical interview, and pain was assessed with the 36-item Short Form Bodily Pain scale. We performed multivariate linear regression to predict satisfaction in outpatients with depression and pain. Minor and major depression were present in 23.4% and 15.0% of the sample, respectively. Pain was present in more than half the patients (50.6%). Both minor and major depression as well as pain severity were strongly associated with lower satisfaction scores. Increased age and diagnosis of heart failure predicted higher satisfaction scores. Depression and pain have a substantial effect on patient satisfaction. Future studies should assess the reasons for dissatisfaction with care in patients with depression and pain.

Key words: ambulatory care, chronic disease, depression, healthcare quality indicator, Medical Outcomes Study, out-patients, pain, patient satisfaction, Patient Satisfaction Questionnaire, rehabilitation.

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