Patient satisfaction with psychiatric outpatient care in Geneva: a survey in different treatment settings

Abstract

Objectives: This study examined client satisfaction in different types of psychiatric outpatient care facilities and its association with treatment setting, patient socio-demographic and clinical variables. Methods: The twelve public outpatient psychiatric clinics for adults in Geneva, Switzerland, offer a rich variety of settings including general psychiatry clinics, crisis centres and specialised programmes for specific disorders (depressive disorders, bipolar disorder, borderline personality disorder, early psychotic disorders and family and marital counselling). A consecutive sample of 918 patients agreed to answer three self-administered satisfaction questionnaires (the CSQ-8 Client Satisfaction Questionnaire measuring global satisfaction, the CIC questionnaire examining various components of service and a qualitative questionnaire with open-ended questions). These forms were adequately completed by 707 subjects, who constituted our study group. Their clinical and socio-demographic characteristics were obtained from their attending psychiatrists. Results: The global satisfaction rate was high (38.5% satisfied and 54.6% very satisfied). Reasons for greater satisfaction were therapeutic interventions, relationship with staff and confidentiality, while a lower satisfaction was related to information on disease and medication, adjustment of the program to patient expectations, clinic organisation and environment. Socio-demographic and clinical characteristics were not homogeneously distributed across the three types of treatment settings. A significantly larger proportion of male, single, pensioned, chronically-ill patients with minimum education were followed at the general psychiatric consultation centers, where diagnosis of schizophrenia was the most frequent. In the crisis centres, non-chronically disabled patients with a short psychiatric history (<1 year) and diagnosis of depression were more prevalent. Logistic regression showed a significant association between high satisfaction and gender (female), civil status (not single), financial resources (not receiving a disability pension or other social aid), main diagnosis (not presenting a psychotic disorder), and setting (attending a specialised programme). A multivariate model including these five variables showed that setting (odds ratio = 1.84 for specialised programmes) and civil status (OR = 0.57 for single subjects) remained significant predictors of satisfaction. Conclusions: The satisfaction of psychiatric outpatients could be improved by adjusting the programme content or setting according to these findings (systematic clarification of patient expectations, more information about disease and medication, appropriate frequency and length of appointments, specialised care and medical follow-up, greater attention to physical environment), but it should be taken into account that client appreciation is also influenced by socio-demographic and clinical characteristics.