Participation in health decision-making and satisfaction of Chilean primary care users

Abstract

Worldwide there is an increasing interest for actively involving patients in healthcare. Particularly in Chile, there are strategies to promote community participation, moving towards the medical decision-making process. However, little is known about how much participation is occurring in the clinical encounters nor how this is linked to patients’ satisfaction with healthcare. Objective: to determine the level of patients’ experienced participation in medical decision-ma- king in Chilean primary care centers (PCC) and its relationship with users’ satisfaction. Methods: A cross-sectional, individual study was conducted. We recruited 24 PCC across the country. Participants (n=2223) were asked to complete a self-reported questionnaire (CollaboRATE-Chile and Satisfaction scale) after the clinical encounter. For bivariate analysis we used Chi-squared test. Results: Patients reported high levels of participation in the decision-making process, and this was only affected if they had poor health perception (p<0,001). Low levels of participation were significantly associated with low satisfaction (p<0,001). Conclusion: PCC users experienced great involvement in the medical decision-making process, and this could impact their satisfaction with healthcare. Future research should deeply explore this phenomenon by using methodologies that can identify the interpersonal relationship component of participation and propose interventions to train both health professionals and patients for a participatory therapeutic encounter.