Evaluation of Satisfaction with Healthcare Services in Multimorbid Patients Using PACIC+ Questionnaire: A Cross-Sectional Study

Gediminas Urbonas; Gediminas Raila; Danielius Serapinas; Leonas Valius; Džilda Veličkienė; Jurgita Plisienė; Lina Vencevičienė; Elena Jurevičienė; Ida Liseckienė

doi:10.3390/medicina59020276

Evaluation of Satisfaction with Healthcare Services in Multimorbid Patients Using PACIC+ Questionnaire: A Cross-Sectional Study

Medicina (Kaunas). 2023 Jan 31;59(2):276. doi: 10.3390/medicina59020276.

Authors

Gediminas Urbonas^{1

2}, Gediminas Raila^{1

2}, Danielius Serapinas¹, Leonas Valius^{1

2}, Džilda Veličkienė^{1

2

3}, Jurgita Plisienė^{1

2}, Lina Vencevičienė^{4

5}, Elena Jurevičienė⁶, Ida Liseckienė^{1

2}

Affiliations

¹ Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania.
² Hospital of Lithuanian University of Health Sciences Kauno Klinikos, LT-50161 Kaunas, Lithuania.
³ Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, LT-50009 Kaunas, Lithuania.
⁴ Clinic of Internal Medicine, Family Medicine and Oncology, Faculty of Medicine, Vilnius University, LT-08661 Vilnius, Lithuania.
⁵ Center of Family Medicine, Vilnius University Hospital Santaros Klinikos, LT-08661 Vilnius, Lithuania.
⁶ Faculty of Medicine, Vilnius University, LT-08661 Vilnius, Lithuania.

Abstract

Background and Objectives: Although multimorbidity poses many challenges for both individuals and healthcare systems, information on how these patients assess the quality of their healthcare is lacking. This study assessed the multimorbid patients' satisfaction with their healthcare. Materials and Methods: This cross-sectional study was a part of a project Joint Action-Chronic Diseases and Promoting Healthy Ageing across the Life Cycle and its implementation. The study included 400 patients with arterial hypertension and at least one concomitant chronic disease. Patients completed The Patient Assessment of Care for Chronic Conditions Plus (PACIC+) questionnaire, EuroQol Five-Dimensions-Three-Level Quality of Life questionnaire, and Hospital Anxiety and Depression scale. Results: The mean age of the participants was 65.38 years; there were 52.5% women. The mean PACIC+ 5As summary score was 3.60. With increasing age, participants rated worse on most PACIC+ subscales. Participants who assessed their quality of life as worse were also less satisfied with their healthcare. The presence of three or more concomitant diseases negatively affected PACIC+ scores. Patients with ischemic heart disease and heart failure had lower PACIC+ scores on most subscales, whereas patients with atrial fibrillation had lower scores only on the Agree subscale. The presence of diabetes was not associated with worse PACIC+ scores; moreover, the scores in Assist and Arrange subscales were even better in diabetic patients (3.36 vs. 2.80, p = 0.000 and 3.69 vs. 3.13, p = 0.008, respectively). Patients with chronic obstructive pulmonary disease, asthma, and musculoskeletal disorders showed lower PACIC+ scores. Conclusions: Older age, worse self-assessed health state, presence of three or more diseases, and certain chronic diseases were associated with lower patients' satisfaction with their healthcare. Personalized healthcare, increasing competencies of primary healthcare teams, healthcare services accessibility, and financial motivation of healthcare providers may increase multimorbid patients' satisfaction with their healthcare.

Keywords: PACIC+; chronic disease; multimorbidity; patient satisfaction; primary healthcare.

MeSH terms

Aged
Chronic Disease
Cross-Sectional Studies
Diabetes Mellitus*
Female
Humans
Male
Multimorbidity*
Patient Satisfaction
Personal Satisfaction
Quality of Life
Surveys and Questionnaires

Grants and funding

This publication derives from the Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS), which has received funding from the European Union in the framework of the Health Programme 2008–2013. Sole responsibility lies with the author and the Consumers, Health, Agriculture and Food Executive Agency is not responsible for any use that may be made of the information contained therein. The preparation of the manuscript was funded by The College of Lithuanian General Practitioners.