Social capital and patient satisfaction with cancer care

OBJECTIVE Patient satisfaction has emerged as a powerful determinant and outcome of health care quality. Patient satisfaction is influenced by their socio-demographic characteristics and their social environment. The objective of this study was to examine the associations between individual level self-reported social capital and patient satisfaction with cancer care. METHOD The study design was cross-sectional. Over 10 consecutive weeks in 2007, 84 in-patients in an oncology department met the inclusion criteria, of whom 52 agreed to participate (62%). They completed, by interview, two questionnaires: The Social Capital Questionnaire (SCQ) and the Comprehensive Assessment of Satisfaction with Care (CASC). Correlational and simple and multiple linear regression analyses (including sex, age and education) were performed among social capital factors (participation in the community, feelings of safety, value of life and social agency, tolerance of diversity) and 11 dimensions of cancer care (medical, nursing, administrative). RESULTS Patient satisfaction rating on a 10-point scale had the highest correlation coefficients with the total social capital score (r=0.570, p<0.001) and with value of life and social agency (r=0.532, p<0.001). In multivariate analyses, the majority of patient satisfaction subscales were related to the total social capital score and to the factor value of life and social agency. Feelings of safety and tolerance of diversity were both correlated with some dimensions of patient satisfaction. Community participation was not related to patient satisfaction. The dimensions of care associated to a greater degree with social capital were those for which patients believe they do not have enough knowledge or experience to make a judgment on (e.g., doctors' technical skills). CONCLUSIONS The results suggest that the social capital of patients is associated with their satisfaction with health care. When individual-level social capital or some of its subscales increase, so does the level of patient satisfaction with certain aspects of cancer care. Patients may show a social predisposition when evaluating health care for reasons unrelated to the actual care received. These results are in agreement with bibliographic documentation of the influence of social capital on health outcomes. The inclusion of social capital will provide more accurate evaluation in patient satisfaction surveys.