Abstract
In recent years, various methods for measuring patient satisfaction have been applied as part of quality improvement programmes. However, the validity and reliability as well as the applicability and change-orientation of adopted methods have been questioned. Furthermore, most methods pay no specific attention to economic aspects. The purpose of this study is to analyse if and how priorities are influenced when an economic perspective is explicitly included. Data were compiled by a patient survey at a gynaecology clinic, inquiring about the patients' views on various quality dimensions, and their willingness to pay for proposed improvements. The parameters of the model are estimated with simultaneous equation methods, based on partial least squares technique. We compare the ranking of proposed improvements derived from a patient satisfaction index, a cost-effectiveness analysis and a cost-benefit analysis, respectively. Our results show that even a methodologically appropriate measurement of patient satisfaction may lead to a cost-ineffective priority setting unless economic consequences are explicitly taken into consideration. Further, it is demonstrated how an analysis including patient preferences as well as economic aspects may be carried out.