A study of levels of patient satisfaction with urban and rural emergency nursing care has uncovered some interesting results.

By Karen Meehan

We have all heard about the city–country divide in medicine, but a Monash researcher has found that this may well extend to the very expectations people have of the health care they receive.

Associate Professor Elaine Duffy of Monash University’s Centre for Rural Health in Traralgon has undertaken research that raises intriguing questions about differences between urban and rural health consumers.

Her study – a collaboration with Dr Barbara Davis of Marshall University in the US – measured the satisfaction with various aspects of nursing practice of more than 100 patients from emergency wards at two major Victorian hospitals, one urban and one rural.

Results showed many similarities between rural and urban patients’ satisfaction levels, with nurses generally praised for their skilled performance. "Patients are getting what they expect from a professional person, and that’s really important, both to the institutions concerned and to the medical authorities," commented Dr Duffy.

Important issues for both urban and rural consumers included waiting time for emergency treatment, communication with medical professionals, and the need to feel supported, secure and cared for in emergency situations.

Dr Elaine Duffy.

Dr Duffy is fascinated by these discrepancies and by the story they might tell about how demographic factors affect expectations of care. While rural consumers’ concern about time for questions might highlight the effects of short-staffing on regional health providers, it may equally reflect a rural preference for more personal contact with professionals.

Communication and attitude to consumers are key elements in the training of future nurses, Dr Duffy argues. While other industry sectors have developed cultures of consumer feedback, health has lagged behind.

A critical outcome of Dr Duffy’s research is the validity and reliability of the Consumer Emergency Care Satisfaction Scale (CECSS), now recommended to Australian health providers. CECSS has been developed by Dr Davis for collecting and analysing patient satisfaction data, being tested worldwide.

Australian results now join her growing databank, which may provide further clues as to how demographic and cultural factors affect consumers’ health care expectations.

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