Public versus private patient priorities and satisfaction in cataract surgery

Background: Despite strong stereotypes of differences, few studies have compared private and public patient priorities and satisfaction, and none in the context of cataract surgery. The objective of this study was to compare samples of private and public patients undergoing day-stay cataract surgery. Methods: Forty-two public patients and 39 private patients were asked to rate the importance of 13 domains that prior research has shown to influence patient satisfaction. Patients were also asked about their waiting time, amount of information they received, and current and expected VF-14 functional ability. One month after surgery, patients recorded their satisfaction with each of the 13 domains. Results: Public patients waited ninefold longer for surgery and had lower preoperative visual function. Nonetheless both groups expected, and achieved, the same level of postoperative outcome. Although 90% of private patients were satisfied with the information they received regarding the surgery, 45% of public patients wanted more. There were significant differences in priorities between private and public patients. After surgery, public patients were less satisfied than private patients, although when accounting for the importance as well as satisfaction of each factor, the level of satisfaction between groups was not different. Conclusions: The dearth of information received by public patients raises important questions whether their surgery decision was sufficiently individualized or adequately consented. Patient satisfaction is an important health outcome, and understanding both the domains of satisfaction, as well as their relative importance to patients, is necessary to improve the overall quality of patient care.