Satisfaction with medical care is frequently measured in health services research but for many different reasons. The widening conceptualizations and uses of satisfaction reported make comparisons between studies difficult. Questions regarding the structure and dimensionality of satisfaction remain. The relation of satisfaction with utilization still requires theoretic and empiric clarification. This article reports on several surveys containing measures of satisfaction conducted in a research program in community pediatrics. Using multidimensional scaling techniques, the stability of the structure of satisfaction and patients' preferences for care is examined across several samples. The different structures that emerged seem to reflect unique patient experience. Several multivariate approaches were applied to study the relation between satisfaction and utilization. A regulatory self-equilibrating model was offered. Satisfaction is seen as a multifaceted concept related to short-term and long-term processes. Specific models are required to link satisfaction to the various health and illness behaviors.
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