This study examines various dimensions of satisfaction with obstetricians among mainland Puerto Ricans using data from a survey administered to a representative sample of 1,219 Puerto Rican mothers. The results indicate that the majority of Puerto Rican women are satisfied with their obstetricians, but they are not typically “extremely” satisfied. Moreover, satisfaction is influenced by the structure of care, the process of care, and the outcome of care. Two aspects of process that are especially important are the continuity and content of care. Although satisfaction is not generally associated with the ethnicity or the gender of physicians, some evidence suggests that patients who utilize public facilities or lack continuity of care tend to be more satisfied if they have a female physician.
Get full access to this article
View all access options for this article.
References
1.
Aharony, L. , and S. Strasser. 1993. Patient satisfaction. What we know about and what we still need to explore. Medical Care Review50 (1): 49-79.
2.
American Medical Association . 1999. Cultural competence compendium. Chicago: American Medical Association.
3.
Auslander, W. F. , S. J. Thompson, D. Dreitzer, and J. V. Santiago. 1997. Mother’s satisfaction with medical care: Perceptions of racism, family stress, and medical outcomes in children with diabetes. Health and Social Work22 (3): 190-199.
4.
Brach, C. , and I. Fraserirector. 2000. Can cultural competency reduce racial and ethnic health disparities? A review and conceptual model. Medical Care and Research Review57 (Suppl. 1): 181-217.
5.
Campbell, S. M. , M. O. Roland, and S. A. Buetow. 2000. Defining quality of care. Social Science & Medicine51 (11): 1611-1625.
6.
Carrillo, J. E. , A. R. Green, and J. R. Betancourt. 1999. Cross-cultural primary care: A patient-based approach. Annals of Internal Medicine130 (10): 829-834.
7.
Cleary, P. D. , and B. J. McNeil. 1988. Patient satisfaction as an indicator of quality of care. Inquiry25 (1): 25-36.
8.
Cooper-Patrick, L. , J. J. Gallo, J. J. Gonzales, H. T. Vu, N. R. Powe, C. Nelson, and D. E. Ford. 1999. Race, gender, and partnership in the patient-physician relationship. Journal of the American Medical Association282 (6): 583-589.
9.
Curry, M. A.1989. Nonfinancial barriers to prenatal care. Women & Health15 (3): 85-99.
10.
Derose, K. P. , and D. W. Baker. 2000. Limited English proficiency and Latinos’ use of physician services. Medical Care Research and Review57 (1): 76-91.
11.
Donabedian, A.1966. Evaluating the quality of medical care. Milbank Memorial Fund Quarterly44 (3): 166-203.
12.
Donabedian, A. . 1980. The definition of quality and approaches to its assessment. Ann Arbor, MI: Health Administration Press.
13.
Donaldson, M. S.2001. Continuity of care: A reconceptualization. Medical Care Research and Review58 (3): 255-290.
14.
Freda, M. C. , H. F. Anderson, K. Damus, and J. R. Merkatz. 1993. Are there differences in information given to private and public prenatal patients?American Journal of Obstetrics and Gynecology169 (1): 155-160.
15.
Ginzberg, E.1991. Access to health care for Hispanics. Journal of the American Medical Association265 (2): 238-241.
16.
Gray, B. , and J. J. Stoddard. 1997. Patient-physician pairing: Does racial and ethnic congruity influence selection of a regular physician?Journal of Community Health22 (4): 247-259.
17.
Guendelman, S. , and S. Witt. 1992. Improving access to prenatal care for Latina immigrants in California: Outreach and inreach strategies. International Quarterly of Community Health Education12 (2): 89-106.
18.
Guyer, B.1990. Medicaid and prenatal care: Necessary but not sufficient. Journal of the American Medical Association264 (17): 2264-2265.
19.
Hall, J. A. , and M. C. Dornan. 1990. Patient sociodemographic characteristics as predictors of satisfaction with medical care: A meta-analysis. Social Science & Medicine30 (7): 811-818.
20.
Hall, J. A. , J. T. Irish, D. L. Roter, C. M. Ehrlich, & L. H. Miller. 1994. Satisfaction, gender, and communication in medical visits. Medical Care32 (12): 1216-1231.
21.
Hall, J. A. , and D. L. Roter. 1998. Medical communication and gender: A summary of research. Journal of Gender-Specific Medicine1 (2): 39-42.
22.
Handler, A. , K. Raube, M. A. Kelley, and A. Giachello. 1996. Women’s satisfaction with prenatal care settings: A focus group study. Birth23 (1): 31-37.
23.
Handler, A. , D. Rosenberg, K. Raube, and M. A. Kelley. 1998. Health care characteristics associated with women’s satisfaction with prenatal care. Medical Care36 (5): 679-694.
24.
Health Resources and Services Administration . 2000. Cultural competence: A journey. Bethesda, MD: Health Resources and Services Administration.
25.
Institute of Medicine . 1988. Prenatal care: Reaching mothers, reaching infants. Washington, DC: National Academy Press.
26.
Institute of Medicine . 2001. Envisioning the National Health Care Quality Report. Washington, DC: National Academy Press.
27.
Jackson, J. L. , J. Chamberlin, and K. Kroenke. 2001. Predictors of patient satisfaction. Social Science & Medicine52 (4): 609-620.
28.
Kogan, M. D. , G. R. Alexander, M. Kotelchuck, and D. A. Nagey. 1994. Relation of the content of prenatal care to the risk of low birth weight. Journal of the American Medical Association271 (17): 1340-1345.
29.
Kogan, M. D. , G. R. Alexander, M. Kotelchuck, D. A. Nagey, and B. W. Jack. 1994. Comparing mothers’ reports on the content of prenatal care received with recommended national guidelines for care. Public Health Reports109 (5): 637-646.
30.
Kogan, M. D. , M. Kotelchuck, G. R. Alexander, and W. E. Johnson. 1994. Racial disparities in reported prenatal care advice from health care providers. American Journal of Public Health84 (1): 82-88.
31.
Komaromy, M. , K. Grumbach, M. Drake, K. Vranizan, N. Lurie, D. Keane, and A. B. Bindman. 1996. The role of black and Hispanic physicians in providing health care for underserved populations. New England Journal of Medicine334 (20): 1305-1310.
32.
Kotelchuck, M. , M. D. Kogan, G. R. Alexander, and B. W. Jack. 1997. The influence of site of care on the content of prenatal care for low-income women. Maternal and Child Health Journal1 (1): 25-34.
33.
Landale, N. S. , R. S. Oropesa, and B. K. Gorman. 2000. Migration and infant death: Assimilation or selective migration among Puerto Ricans?American Sociological Review65 (6): 888-909.
34.
Lazarus, E. S. , and E. H. Philipson. 1990. A longitudinal study comparing prenatal care of Puerto Rican and white women. Birth17 (1): 6-11.
35.
Lowry, L. W. , J. Saeger, and S. Barnett. 1997. Client satisfaction with prenatal care and pregnancy outcomes. Outcomes Management for Nursing Practice1 (1): 29-35.
36.
Mathews, T. J. , M. F. MacDorman, and F. Menacker. 2002. Infant mortality statistics from the 1999 period linked birth/infant death data set. National Vital Statistics Reports50 (4).
37.
Morales, L. S. , W. E. Cunningham, J. A. Brown, H. Liu, and R. D. Hays. 1999. Are Latinos less satisfied with communication by health care providers?Journal of General Internal Medicine14 (7): 409-417.
38.
Moss, N. E. , and K. Carver1998. The effect of WIC and Medicaid on infant mortality in the United States. American Journal of Public Health88 (9): 1354-1361.
39.
National Center for Health Statistics . 2001. National Health Interview Survey, 2000.Computer file. Hyattsville, MD: U.S. Department of Health and Human Services.
40.
Oberg, C. N. , B. Lia-Hoagberg, C. Skovholt, E. Hodkinson, and R. Vanman. 2001. Prenatal care use and health insurance status. Journal of Health Care for the Poor and Underserved2 (2): 270-292.
41.
Omar, M. , and R. F. Schiffman. 1995. Pregnant women’s perceptions of prenatal care. Maternal-Child Nursing Journal23 (4): 132-142.
42.
Oropesa, R. S. , and N. S. Landale. 1997. Immigrant legacies: Ethnicity, generation, and children’s familial and economic Lives. Social Science Quarterly78 (2): 399-416.
43.
Oropesa, R. S. , and N. S. Landale. 2000. From austerity to prosperity? Migration and child poverty among main-land and island Puerto Ricans. Demography27 (3): 323-338.
44.
Oropesa, R. S. , and N. S. Landale. 2002. Nonresponse in follow-back surveys of ethnic minority groups: An analysis of the Puerto Rican Maternal and Infant Health Survey. Maternal and Child Health Journal6 (1): 49-58.
45.
Oropesa, R. S. , N. S. Landale, and A. L. Dávila. 2001. Poverty, prenatal care, and infant health in Puerto Rico. Social Biology48 (1/2): 67-85.
46.
Oropesa, R. S. , N. S. Landale, M. Inkley, and B. K. Gorman. 2000. Prenatal care among Puerto Ricans on the U.S. mainland. Social Science and Medicine51 (12): 1723-1739.
47.
Palmer, R.Heather, A. Donabedian , and G. Povar. 1991. Striving for quality in health care. Ann Arbor, MI: Health Administration Press.
48.
Pasko, T. , and B. Seidman. 2002. Physician characteristics and distribution in the US: 2002-2003 edition. Chicago: American Medical Association.
49.
Queiro-Tajali, I.1989. Hispanic women’s perceptions and use of prenatal care services. Affilia4 (2): 60-72.
50.
Quesada, G.1976. Language and communication barriers for health delivery to a minority group. Social Science & Medicine10 (6): 323-327.
51.
Radecki, S. E. , and G. S. Bernstein. 1989. Use of clinic versus private family planning care by low-income women: Access, cost, and patient satisfaction. American Journal of Public Health79 (6): 692-697.
52.
Roter, D. L. , G. Geller, B. A. Bernhardt, S. M. Larson, and T. Doksum. 1999. Effects of obstetrician gender on communication and patient satisfaction. Obstetrics & Gynecology93 (5): 635-641.
53.
Rubin, D. B.1987. Multiple imputation for nonresponse in surveys. New York: Wiley.
54.
Saha, S. , M. Komaromy, T. D. Koepsell, and A. B. Bindman. 1999. Patient-physician racial concordance and the perceived quality and use of health care. Archives of Internal Medicine159 (9): 997-1004.
55.
Saha, S. , S. H. Taggart, M. Komaromy, and A. B. Bindman. 2000. Do patients choose physicians of their own race?Health Affairs19 (4): 76-83.
56.
Schafer, J. L.1997. Analysis of incomplete multivariate data. London: Chapman & Hall.
57.
Schur, C. L. , A. B. Berenstein, and M. L. Berk. 1987. The importance of distinguishing Hispanic subpopulations in the use of medical care. Medical Care25 (7): 627-641.
58.
U.S. Bureau of the Census . 2001. Current Population Survey. Retrieved from http://www.census.gov/population/socdemo/hispanic/p20-535/tab14-1.txt.
59.
van Ryn, M. , and J. Burke. 2000. The effect of patient race and socio-economic status on physicians’ perceptions of patients. Social Science & Medicine50 (6): 813-828.
60.
Weitzman, B. C.1995. Improving quality of care. In Health care delivery in the United States, 5th ed., edited by A. R. Kovner, 374-400. New York: Springer.
61.
Wilcock, A. , L. Kobayashi, and I. Murray. 1997. Twenty-five years of obstetric patient satisfaction in North America: A review of the literature. Journal of Perinatal & Neonatal Nursing10 (4): 36-47.
62.
Zavala-Martinez, I.1994. Entremundos: The psychological dialectics of Puerto Rican migration and its implications for health. In Puerto Rican women and children: Issues in health, growth, and development, edited by G. Lamberty and C. C. Garcia, 29-38. New York: Plenum.
