Customer Satisfaction and Health Care Delivery Systems: Commentary with Australian Bias

As the health care industry strains the nation's financial resources it has come under increased pressure to provide evidence of quality controls and quality improvements. Increasing evidence that the service aspects of health care are closely linked to health care outcomes has caught the attention of industry leaders. The current health care consumer is better educated and the best informed it has ever been. Health care organizations must address those aspects of service that consumers most readily appreciate: access to care; relationships between physicians, meaningful and understandable information; and participation in their own health care and treatment decision making processes. One aspect of health care quality that is being increasingly recognized for its importance is the influence of patient perception. Even though the patient's perception of quality relies more on the service aspects of health care, it correlates well with objective measures of health care quality. A health care organization's ability to satisfy consumer demand for convenience and information can significantly influence the quality of health care it ultimately delivers. The health care service industry is complex with multiple facets and levels of organization. Health care system management has previously been relatively inefficient, incoherent and supply driven, keeping customers on the outside of the product design, development and the delivery process. Today there is a shift to an organization model in which the customer influences every function and managers must adapt and be instrumental in establishing a cultural change within the system to meet the new quality focus. Many physicians doubt that the current emphasis on quality is really aimed at improving patient's health. There is paucity of evidence that, as a whole quality initiatives actually do anything to improve outcomes for patients. Physicians however are in the best position to make a case for improving quality. Showing leadership in assessing and improving the quality of care can not only improve outcomes for patients, but also give physicians renewed autonomy over the practice of medicine. There are a number of ways in which the community and consumers may participate in the development of health care policy. These can range from passive consultations to structural participation is an engaged and developmental process in which community control predominates. Unfortunately entrenched biases of researchers and practitioners can limit community involvement. Reform of bureaucratic structures, curriculum and research methodology are all required to effectively involve the health care consumer. Although there is strong evidence in favor of consumer participation care and due diligence however needs to be exercised to ensure that consumer rights are not over emphasized at the expense of health care quality.