Usefulness of multilevel analysis of satisfaction questionnaires on clinical units and medical specialties

Objectives: Evaluate the usefulness of multilevel analysis applied to satisfaction surveys to assess the ambulatory care offered by the Clinical Units and Medical Specialties. Methods: Telephone surveys were conducted on 6,922 patients seen in outpatient visits in the Navarra Health System in order to assess 94 Clinical Units and 37 Medical Specialties. A hierarchical analysis was then performed at 3 levels (patients, Clinical Units and Medical Specialties). Results: The patient explained between 91.7% and 99.3% of the variability in the satisfaction survey scores. The patient perception of service quality also depends of the clinical unit, in 18 out of 20 items analysed, the variance related to the Clinical Unit was statistically significant, and ranged from 0.9% and 8.3%. The Medical Specialty explained 4.2% of the variability in only one item. Patients aged under 65 years, patients seen in first visit, and those who were seen at tertiary hospitals gave the lowest scores. Conclusions: Multilevel analysis is a useful tool to analyse and compare satisfaction survey results, as it can correctly distinguish the different Clinical Units of a health service, and this is a key element in the management of these Units. Moreover, it gives the percentage of variability due to each level and which variables predict the quality of service obtained. (C) 2011 SECA. Published by Elsevier Espana, S.L. All rights reserved.