Patients' Ratings of Outpatient Visits in Different Practice Settings: Results From the Medical Outcomes Study

To determine how patients in different kinds of practices—solo or single specialty (SOLO), multispecialty group (MSG), or health maintenance organizations (HMOs)—and with fee-for-service (FFS) or prepaid physician payment arrangements evaluate their medical care. Survey of adult outpatients after office visits, with sample weighted to represent population of patients visiting physicians in each practice type. Offices of 367 internists, family practitioners, endocrinologiste, cardiologists, and nurse practitioners, in HMOs (prepaid only), MSGs (prepaid and FFS), and SOLO practices (prepaid and FFS). Adults (N=17671) at start of the Medical Outcomes Study. Overall rating of the visit (five choices from excellent to poor). A random half of the sample also rated the provider's technical skills, personal manner, and explanations of care as well as time spent during the visit, the appointment wait, the office wait, the convenience of the office location, and telephone access. Fifty-five percent of patients rated their visit overall as excellent, 32% very good, 11% good, and 2% fair or poor. Patients of SOLO practitioners were more likely (64%) to rate their visit excellent than MSG (48%) or HMO (49%) patients (P