Patient-reported experience, patient-reported outcome and overall satisfaction with care: What matters most to people with diabetes?

Abstract

Diabetes management has become a critical healthcare challenge globally, emphasizing the need for patient-centered care to improve the quality of services and enhance treatment outcomes. Patient experiences, perceived outcomes, and satisfaction are crucial to optimizing healthcare delivery, but each reflects different aspects of care. Understanding how these measures relate to each other is key to improving healthcare evaluation and avoiding dependence on a single metric. This study examines how patient-centered care (PCC) is associated with patient-reported experience measures (PREMs) and patient-reported outcome measures (PROMs), as well as overall patient satisfaction (PS) among people with diabetes. This study uses cross-sectional quantitative data from a structured, interviewer-administered questionnaire in 47 primary healthcare centers in Jeddah, Saudi Arabia, and is reported in accordance with the CROSS (Consensus-Based Checklist for Reporting of Survey Studies) guidelines. A total of 594 people with diabetes were recruited using random sampling from these centers. PCC was measured using the PCC-36 instrument. PREMs and PROMs were assessed using items adapted from the Swedish National Diabetes Register, while PS was measured using a validated single-item scale. Each was evaluated as a continuous measure, where higher scores indicate more positive experiences, outcomes, or satisfaction. A regression analysis was conducted to investigate the interrelationships between PREMs, PROMs, and PS and control for the effect of relevant sociodemographic and health-related characteristics. The data analysis was carried out using STATA 18. The results of the study indicated that PCC had a significant positive relationship with PROMs (β = 0.316, p < 0.01), PREMs (β = 0.063, p < 0.05), and PS (β = 0.689, p < 0.01). A strong residual correlation was observed between PREMs and PROMs (β = 0.734, p < 0.01), while the residual association between PREMs and PS was minimal (β = 0.063, p < 0.05). Emotional support was significantly associated with PROMs (β = 0.170, p < 0.01) and PREMs (β = 0.078, p < 0.01) but had a negative association with PS (β = -0.084, p < 0.1). Family and friends' involvement was a significant predictor of PROMs (β = 0.193, p < 0.01), PREMs (β = 0.125, p < 0.01), and PS (β = 0.082, p < 0.05). Physical comfort was positively associated with PS (β = 0.128, p < 0.01) but negatively associated with PROMs (β = -0.143, p < 0.01) and PREMs (β = -0.056, p < 0.05). Access to care is significantly associated with PS (β = 0.176, p < 0.01). This study highlights the crucial role of PCC, showing that higher levels of PCC are associated with more positive patient experiences, health outcomes, and satisfaction among people with diabetes. Key PCC factors include emotional support, involvement of family and friends, and access to care. Thus, patient-centered practices must be integral to quality improvement strategies in diabetes care. Although variations in PCC largely explain variations in patient-reported measures and satisfaction among people with diabetes, variations in omitted or unobserved factors drive these measures. These findings highlight the importance of further investigating the nature and relation between PS, PROMs, and PREMs and their use in tailoring care to patient priorities.