Waiting time and assessment of patient satisfaction in a large reference emergency department: a prospective cohort study, France.

Objectives: To assess patient satisfaction in a French Emergency Department (ED) and to determine factors associated with dissatisfaction.

Methods: From July 2003 to February 2004, a prospective cohort study was conducted in an ED (Elbeuf Reference Hospital, Upper-Normandy region). Baseline data collection was performed during individual interview at inclusion. Waiting time in the ED was recorded. Patient satisfaction was assessed by telephone 1 month later. Questions included assessment of overall satisfaction and three different areas of satisfaction: quality of reception, patient-doctor communication, and delays.

Results: One hundred sixty-five patients were included, 146 patients (88.5%) responded to the telephone follow-up. We found high levels of satisfaction in the ED (89.7%). Highest satisfaction rate (92.5%) was for reception. Lower satisfaction rates were reported for waiting times (72.6%) and medical information provided by physicians (71.9%). The mean total time spent was 149.9 min (median=133.5). In multivariate analysis, waiting time was the unique independent determinant of patient dissatisfaction: second quartile odds ratio (OR)=0.40; 95% confidence interval (CI)=(0.06-2.66), third quartile OR=1.45; 95% CI=(0.32-6.47), last quartile OR=2.69; 95% CI=(0.65-11.08); ptrend=0.04.

Conclusion: Elevated waiting times appeared as the unique independent risk factor of patient dissatisfaction. Information on delays and reasons for this delay could be systematically communicated to patients attending EDs; it could be an effective strategy to reduce perceived waiting times and improve patient satisfaction.