IDEAS home Printed from
MyIDEAS: Log in (now much improved!) to save this article

The importance of patient expectations as a determinant of satisfaction with waiting times for hip and knee replacement surgery

Listed author(s):
  • Conner-Spady, Barbara L.
  • Sanmartin, Claudia
  • Johnston, Geoffrey H.
  • McGurran, John J.
  • Kehler, Melissa
  • Noseworthy, Tom W.
Registered author(s):

    Objectives The disconfirmation model hypothesizes that satisfaction is a function of a perceived discrepancy from an initial expectation. Our objectives were: (1) to test the disconfirmation model as it applies to patient satisfaction with waiting time (WT) and (2) to build an explanatory model of the determinants of satisfaction with WT for hip and knee replacement.Methods We mailed 1000 questionnaires to 2 random samples: patients waiting or those who had received a joint replacement within the preceding 3-12 months. We used ordinal logistic regression analysis to build an explanatory model of the determinants of satisfaction.Results Of the 1330 returned surveys, 1240 contained patient satisfaction data. The sample was 57% female; mean age was 70 years (SD 11). Consistent with the disconfirmation model, when their WTs were longer than expected, both waiting (OR 5.77, 95% CI 3.57-9.32) and post-surgery patients (OR 6.57, 95% CI 4.21-10.26) had greater odds of dissatisfaction, adjusting for the other variables in the model. Compared to those who waited 3 months or less, post-surgery patients who waited 6 to 12 months (OR 2.59, 95% CI 1.27-5.27) and over 12 months (OR 3.30, 95% CI 1.65-6.58) had greater odds of being dissatisfied with their waiting time. Patients who felt they were treated unfairly had greater odds of being dissatisfied (OR 4.74, 95% CI 2.60-8.62).Conclusions In patients on waiting lists and post-surgery for hip and knee replacement, satisfaction with waiting times is related to fulfillment of expectations about waiting, as well as a perception of fairness. Measures to modify expectations and increase perceived fairness, such as informing patients of a realistic WT and communication during the waiting period, may increase satisfaction with WTs.

    If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.

    File URL:
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.

    Article provided by Elsevier in its journal Health Policy.

    Volume (Year): 101 (2011)
    Issue (Month): 3 (August)
    Pages: 245-252

    in new window

    Handle: RePEc:eee:hepoli:v:101:y:2011:i:3:p:245-252
    Contact details of provider: Web page:

    References listed on IDEAS
    Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:

    in new window

    1. Brooks, Richard AU -, 1996. "EuroQol: the current state of play," Health Policy, Elsevier, vol. 37(1), pages 53-72, July.
    2. Oliver, Richard L & Swan, John E, 1989. " Equity and Disconfirmation Perceptions as Influences on Merchant and Product Satisfaction," Journal of Consumer Research, Oxford University Press, vol. 16(3), pages 372-383, December.
    3. Linder-Pelz, Susie, 1982. "Toward a theory of patient satisfaction," Social Science & Medicine, Elsevier, vol. 16(5), pages 577-582, January.
    4. Siciliani, Luigi & Hurst, Jeremy, 2005. "Tackling excessive waiting times for elective surgery: a comparative analysis of policies in 12 OECD countries," Health Policy, Elsevier, vol. 72(2), pages 201-215, May.
    5. Edwards, Rhiannon Tudor & Boland, Angela & Wilkinson, Clare & Cohen, David & Williams, John, 2003. "Clinical and lay preferences for the explicit prioritisation of elective waiting lists: survey evidence from Wales," Health Policy, Elsevier, vol. 63(3), pages 229-237, March.
    Full references (including those not matched with items on IDEAS)

    This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

    When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:101:y:2011:i:3:p:245-252. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu)

    or ()

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If references are entirely missing, you can add them using this form.

    If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    This information is provided to you by IDEAS at the Research Division of the Federal Reserve Bank of St. Louis using RePEc data.