Measuring Patients' Expectations and Requests

Measuring Patients' Expectations and Requests

Richard L. Kravitz, MD, MSPH

From the University of California, Davis, Sacramento, California. Note: This article is one of a series of articles comprising an Annals of Internal Medicine supplement entitled “ Investigating Symptoms: Frontiers in Primary Care Research—Perspectives from The Seventh Regenstrief Conference ” To see a complete list of the articles included in this supplement, please view its Table of Contents.

Abstract

Patients seeking help for symptoms frequently worry about the underlying causes of their symptoms; have specific expectations for care; and request (or demand) time, information, and services. Understanding patients' concerns, expectations, and requests is important for clinicians, health care policymakers, and researchers. One obstacle to progress in this area has been disagreement over the most appropriate methods for identifying, monitoring, and classifying these phenomena. This article reviews the conceptual relationships linking patients' expectations, requests, and satisfaction with care; surveys contemporary approaches to the measurement of expectations and requests; and highlights recent empirical findings. The literature reviewed supports the conclusion that patients' expectations are wide ranging, can be measured, and have potentially important clinical consequences. For clinicians and policymakers alike, learning to elicit, evaluate, and understand patients' expectations will be a major task for the early part of the new century.

Article and Author Information

Grant Support: By grant 034384 from the Robert Wood Johnson Foundation and grant R03 HS09812-01 from the Agency for Healthcare Research and Quality. Dr. Kravitz was a Picker-Commonwealth Faculty Scholar when this work was initiated.
Current Author Address: Richard L. Kravitz, MD, MSPH, Center for Health Services Research in Primary Care, University of California, Davis, 4150 V Street, PSSB Suite 2500, Sacramento, CA 95817; e-mail, rlkravitz{at}ucdavis.edu.