2013 VHA Customer Satisfaction Report
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American Customer Satisfaction Index
Veterans Health Administration Veterans Affairs
2013 Customer Satisfaction Outpatient Survey
Final Report March 2014
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Table of Contents
Page Introduction and Methodology 5
Introduction 5 Customer Segment 5 Customer Background 5
ACSI Results 8
Model Indices 8 Satisfaction: ACSI 10 Drivers of Satisfaction 11 Outcomes of Satisfaction 12 Using the Model 13 Summary and Recommendations 13
Appendices
A Survey Questionnaire 15 B Score Tables 25 C Frequencies of Survey Questions 31 D Disposition Report 41
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Introduction and Methodology
Introduction This is the 2013 report on customer satisfaction of veterans who have had a recent experience as outpatients at acute medical centers of the Veterans Health Administration (VHA). The methodology used for this study is that of the American Customer Satisfaction Index (ACSI) which combines survey input with cause and effect modeling to produce indices of satisfaction, and the drivers and outcomes of satisfaction.
Since 1994, the American Customer Satisfaction Index has been a national indicator of customer evaluations of the quality of goods and services available to U.S. residents. It is the only uniform, cross-industry/government measure of customer satisfaction. It produces indices of satisfaction, its causes and effects, for 10 economic sectors, 43 industries, 200 private sector companies, two types of local government services, the U.S. Postal Service, and a substantial portion of federal government. ACSI allows benchmarking between the public and private sectors, and for each customer segment, between one year’s result and the next. ACSI is a useful tool for improving practices and processes. It shows how customers evaluate the activities VHA does and identifies which of these activities has the most impact on the perception of the quality the agency delivers. Results can be used to prioritize future efforts to improve quality and, through quality, customer satisfaction and the desired outcome, Veteran’s Loyalty. The questionnaire used is shown in Appendix A. It was designed to be agency-specific in terms of activities, outcomes, and introductions to the questionnaire and to specific question areas. However, it follows a format, common to all federal agency questionnaires, which allows cause and effect modeling using the ACSI model.
Customer Segment VHA chose as its customer segment (Outpatients) veterans recently discharged from a VHA acute medical center to home in 2013. VHA provided sample with names, phone numbers, and addresses for individuals who met the criteria described above.
Customer interviews were conducted by telephone between February 6 - 12, 2014 by the professional interviewers of ASVA working under monitored supervision from a central phone room. Interviewers used CATI (computer-assisted-telephone-interviewing) terminals programmed for the specific questionnaire. Appendix D contains a complete disposition of the response rate for this study. Response rate as calculated by AAPOR standards was 26.5%.
Respondent Background Ninety-one percent of respondents have an assigned provider or team in charge of their medical care and 93% of recent visits were scheduled. Just 12% of respondents were under the age of 50, while those in their 60s made up the largest age segment at 40%. Ninety-four percent of those surveyed had at least earned a high school diploma, and 30% were at least four-year college graduates. Half of the respondents had income between $20,000 and $40,000 and just over one-quarter (26%) had income under $20,000. The vast majority of the surveyed population are male (93%).
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Percent Frequency Percent FrequencyHave an assigned provider or team in charge of medical careNo, do not have provider or team 6% 15 9% 21Yes, have provider or team 94% 221 91% 218Number of Respondents
Recent clinic visit was scheduled or a Walk-inScheduled 90% 218 93% 224Walk-in 10% 24 7% 17Number of Respondents
Clinic visit was a Walk-in because of an emergency condition or illnessWas not an emergency 50% 12 53% 9Was because of an emergency 50% 12 47% 8Number of Respondents
AgeUnder 50 14% 33 12% 2950-59 10% 23 14% 3460-69 42% 99 40% 9770-79 21% 49 19% 4580 and over 14% 34 15% 35Number of Respondents
Highest level of education completedLess than high school 8% 18 6% 14High school graduate 29% 70 29% 69Some college or associate degree 38% 91 36% 86College graduate 15% 37 20% 47Post-graduate 10% 24 10% 25Number of Respondents
Hispanic Latino or Spanish originNot Hispanic origin 93% 220 93% 219Hispanic origin 7% 17 7% 17Number of Respondents
2012 2013
236 239
242 241
24 17
238 240
240 241
237 236
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Percent Frequency Percent FrequencyRace~White 81% 190 91% 214African American 12% 28 7% 17American Indian 1% 2 2% 4Asian 0% 1 0% 0Native Hawaiian - Pacific Islander 0% 0 0% 0Other Race 8% 18 2% 4Number of Respondents
Total annual family income in 2013Under $20,000 32% 67 26% 54$20,000 but less than $30,000 22% 47 33% 67$30,000 but less than $40,000 19% 40 17% 35$40,000 but less than $60,000 15% 31 14% 28$60,000 but less than $80,000 6% 12 5% 10$80,000 but less than $100,000 4% 8 2% 5$100,000 or more 3% 6 3% 7Number of Respondents
GenderMale 92% 223 93% 224Female 8% 19 7% 17Number of Respondents
Complained to VA Medical Center within the past yearDid not complain 89% 215 92% 221Complained 11% 27 8% 20Number of Respondents
2012 2013
242 241
242 241
236 235
211 206
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ACSI Results
Model Indices The government agency ACSI model is a variation of the model used to measure private sector companies. Both were developed at the National Quality Research Center of the Ross School of Business at the University of Michigan. Whereas the model for private sector, profit-making, companies measures Customer Loyalty as the principal outcome of satisfaction (measured by questions on repurchase intention and price tolerance), each government agency, defined the outcome most important to it for the customer segment measured. Each agency also identified the principal activities that interface with its customers. The effects of these activities on customer satisfaction/dissatisfaction are estimated by the model. Thus the model, shown on page 9 for VHA Outpatients should be viewed as a cause and effect model that moves from left to right, with satisfaction (ACSI) in the middle. The circles are multi-variable components that are measured by several questions (question topics are shown on the left side of the small arrows). The large arrows connecting the components in the circles represent the strength of the effect of the component on the left to the one to which the arrow points on the right. These arrows represent "impacts." The larger the number on the arrow, the more effect the component on the left has on the one on the right. The 2013 VHA model for veterans who recently had an episode of care as an outpatient at a VHA clinic is shown on the next page. The meanings of the numbers shown in the model are the topic of the rest of this chapter.
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81
Perceived Quality
Customer Expectations
Satisfaction Disconfirm
Comparison
Veterans Medical Center
81
Pharmacy
73
Customer Service
91
0.4
3.9
0.8
85
0.3
4.6
0.0
75
- 2.7
Customer Complaints
8%
Veterans Loyalty
93 85 79
Waiting Time 73
Customer Satisfaction
Expectations 82
82
Confirm/ to Ideal
3.0
Accessibility
91 Courtesy of Appt. Personnel Courtesy of Medical Provider 92 Professionalism 90
- 0.1 Reuse
95
Advocacy 92
Complaint Behavior
Overall 85
Overall 75
VHA Outpatient
Customer Segment: Veterans with one or more episodes of care as an outpatient in any of VHA’s outpatient clinics
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Satisfaction: ACSI The ACSI is a weighted average of three questions, Q11, Q12, and Q13, in the questionnaire in Appendix A. The questions are answered on 1-10 scales, but the weighted average is transposed and reported as an index on a 0-100 scale.1 The three questions measure: Overall satisfaction (Q11); Fallen short of or exceeded expectations (Q12); and Comparison to an ideal (Q13). The model does the weighting to maximize the effect of satisfaction on the agency outcome at the bottom right of the model.
The 2013 customer satisfaction index (ACSI) for VHA outpatients matches last year’s score of 82 on a 0-100 scale. VHA Outpatient care is now just below the ACSI measure for the private sector hospital outpatient industry. The chart below shows satisfaction scores for both VHA inpatient and outpatient segments, compared with the aggregate private hospital score and its three components (outpatient, inpatient and emergency room care). The VHA Outpatient satisfaction score is one point lower than the industry score for Outpatients but five points above the hospital industry average overall.
1 The confidence interval for this agency's customer segment is plus or minus 2.2 points on a 0-100 scale at the 90% confidence level.
66
70
78
80
82
83
84
Federal Government
Hospital Industry - Emergency
Hospital Industry - Overall
Hospital Industry - Inpatients
VA Outpatients
Hospital Industry - Outpatients
VA Inpatients
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Drivers of Satisfaction VHA identified three areas that interface with its customers, Veteran’s Medical Center, Pharmacy and Customer Service. The indices for each of the three activities are weighted averages of questions asked on the survey.
Two other components were included in the satisfaction model as potential drivers of customer satisfaction. The first is the customer's expectations of the overall quality of VHA as an agency; expectations prior to use or, for longer-term users, prior to recent use (Q1). The second is his/her perception of the overall quality of VHA as an agency after having had experience doing such business (Q10).
Customer Service is the main driver of perceptions of quality, which in turn is the key driver of satisfaction. Although down two points from last year, Customer Service remains the greatest strength for VA with a score of 91. Medical providers and appointment personnel remain highly courteous with scores of 92 and 91, respectively. Medical providers are also highly professional (90). Ratings for Veterans Medical Center accessibility (81) have declined five points from last year. However, wait time for the Pharmacy improved slightly to 73, which was up two points. Relative to Customer Service, which has an impact of 3.9, these two areas have very modest impacts on perceptions of quality. Access to Veterans Medical Center has an impact of 0.8 and Pharmacy wait time has an impact of 0.4. Customer Expectations are down three points to 75 and Perceived Quality is down two points to 85. Perceived Quality continues to far outperform expectations with a 10-point gap between the two. In the satisfaction model, Perceived Quality is the main driver of satisfaction and has the highest direct impact on Satisfaction (4.6).
2004 2005 2006Sample Size 254 254 256Veterans Medical Center 81 79 83 82 80 84 80 82 86 81Pharmacy 74 74 72 74 74 75 74 74 71 73Customer Service 91 89 90 92 91 91 91 92 93 91Customer Expectations 78 75 75 78 75 79 77 76 78 75Quality 86 84 85 87 85 87 86 87 87 85Customer Satisfaction 83 80 82 83 81 83 82 83 82 82
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Outcomes of Customer Satisfaction
Customer Complaints Complaints decreased to 8%, the lowest level over the course of the VHA Outpatients study. Ease of making a complaint dropped to 46, down 16 points from 2012, and handling of complaint was much lower at 24. The handling of complaints has plummeted since 2011, when it came in at 56. Although this is a substantial drop, it should be noted that the 2013 score is based on a small sample size of 19 of those who complained.
Veterans Loyalty The outcome VHA wants from satisfied customers is Veterans Loyalty. Veterans’ Loyalty for this model was measured by two questions: how likely is it that you will use the VA Medical Center again in the future when you need Outpatient medical care (Q15) and how willing would you be to say positive things about Outpatient care at the VA Medical Center to other veterans (Q16).
The 2013 index of Veterans Loyalty remains the same as it was last year at 93 on a 0-100 scale. Loyalty to VA is at its highest historical level as patients are very willing to say positive things about Outpatient care (92) and indicate a strong willingness to use a VA medical center the next time they need Outpatient care (95).
2004 2005 2006Sample Size 254 254 256Loyalty 92 90 92 92 91 92 90 92 93 93Complaints 15% 13% 15% 17% 17% 14% 14% 10% 11% 8%Handling of complaint -- -- -- 53 59 57 47 56 46 24Ease of making complaint -- -- -- 65 75 74 55 64 62 46
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Using the Model In order to improve customer satisfaction, it is recommended to focus on improving the higher-impact, lower-performing drivers as a priority.
The impact scores shown in the customer satisfaction model on page 9 should be read as the effect on the subsequent component if the component on the left of the arrow were to be improved by 5 points. For example, if Customer Service were improved by 5 points, Perceived Quality would go up by the value of the impact (3.9) from 85 to 88.9. Customer Satisfaction (ACSI) would, in turn increase by 3.6 points to become 85.6.2
Summary and Recommendations Outpatient satisfaction with VHA remains unchanged from last year at 82. Historically, this measure has been very stable as eight of the past 10 measures of CSI have either been 82 or 83. Currently the VHA is however, one point below the industry average for outpatient satisfaction (83). Customer Service remains the key driver of perceptions of quality and in turn, satisfaction. While courteousness and professionalism rate highly, there may be opportunities for slight improvement as this component was rated two points higher last year. Accessibility of the VA Medical Center should also be a target for improvement. This area had a significant five-point drop in score in 2013. Pharmacy wait time remains the lowest rated area but also has a very modest impact on perceptions of quality and satisfaction. As such, the focus for VHA should be on Customer Service and access to VA Medical Centers. Lastly, complaints are at a historical low at just 8%. However, the handling of complaints and ease of making complaints have fallen substantially as well and should be areas to address.
2 The computation for Customer Service’s impact on satisfaction is: (Customer Service’s impact on Perceived Quality/5 x Perceived Quality’s impact on satisfaction) or (3.9/5) x 4.6 = 3.6.
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APPENDIX A:SURVEY QUESTIONNAIRE
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American Customer Satisfaction Index VHA Outpatient
Veterans Affairs: Veterans Health Administration
PROG. NOTE: Move in CONTACT NAME from sample [CONTACT NAME]: FNAME LNAME FROM SAMPLE ________________________________________________________________________ May I speak with (RESTORE CONTACT NAME)? Hello, I'm (NAME) calling on behalf of the CFI Group. Today I want to ask you about services you may have received from the VA Medical Center. The purpose of the research is to help the Veterans Health Administration improve its services to veterans. Your name will be confidential, and you may stop at any time or skip any question you do not wish to answer. This interview is authorized by Office of Management and Budget Control No. 1090-0007 which expires on March 31, 2015. This interview will take approximately 8-10 minutes. ________________________________________________________________________ PROG. NOTE: TERMINATE SCREEN Those are all of the questions I have for you. Thank you for your interest in this project. ________________________________________________________________________
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Now, I am going to ask you some questions about the VA Medical Center with which you have had experience.
Q1. Before you recently used the VA Medical Center, you probably knew something about that VA Medical Center. Now think back and remember your expectations of the overall quality of the VA Medical Center. Please give me a rating on a 10 point scale on which "1" means your expectations were "not very high" and "10" means your expectations were "very high."
How would you rate your expectations of the overall quality of the VA Medical Center you recently visited?
[RECORD NUMBER 1-10] DK REF
________________________________________________________________________ Now, let's think about who gives you your medical care at the VA Medical Center you recently visited…
Q2. Do you have an assigned provider or a team in charge of your medical care at that VA Medical Center?
1 Yes, one medical care provider or team 2 No DK REF
________________________________________________________________________ Now, let’s talk about the kind of service you get at the VA Medical Center you recently
visited…
Q3. How accessible and easy to use is that VA Medical Center for you? Use a 10-point scale again on which “1” means “very inaccessible and difficult to use” and “10” means “very accessible and easy to use.” How inaccessible or accessible is that VA Medical Center?
[RECORD NUMBER 1-10] DK REF
________________________________________________________________________
Q4. How courteous are the appointment personnel? On a 10 point scale on which “1” means “not at all courteous” and “10” means “very courteous,” how courteous are the appointment personnel?
[RECORD NUMBER 1-10] DK
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REF ________________________________________________________________________
Q5. And how courteous are the medical providers? On a 10 point scale on which “1” means “not at all courteous” and “10” means “very courteous,” how courteous are those who provide your medical care?
[RECORD NUMBER 1-10] DK REF
________________________________________________________________________
Q6. How professional are the medical providers in terms of being knowledgeable, helpful, and responsive? On a 10-point scale on which “1” means “not at all professional” and “10” means “very professional,” how professional are those who provide your medical care?
[RECORD NUMBER 1-10] DK REF
________________________________________________________________________ Now, think about the pharmacy at the VA Medical Center you recently visited…
Q7. How long is the waiting time for you to obtain your prescriptions from the pharmacy located at that VA Medical Center. Please rate the waiting time for prescriptions on a 10-point scale on which “1” means “very slow” and “10” means “very fast.”
[RECORD NUMBER 1-10] 11 Did not use pharmacy DK REF
________________________________________________________________________
Q10. Please consider all your experiences in the past two years with the VA Medical Center you recently visited. Using a 10-point scale, on which "1" means "not very high" and "10" means "very high," how would you rate the overall quality of that VA Medical Center?
[RECORD NUMBER 1-10] DK REF
________________________________________________________________________ Satisfaction includes many things. Let's move on and talk about your overall satisfaction with the VA Medical Center you recently visited.
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Q11. First, please consider all your experiences to date with that VA Medical Center. Using a 10 point scale on which “1” means “very dissatisfied” and 10 means “very satisfied,” how satisfied are you with that VA Medical Center?
[RECORD NUMBER 1-10] DK REF
________________________________________________________________________
Q12. Considering all of your expectations, to what extent has that VA Medical Center fallen short of your expectations or exceeded your expectations? Using a 10-point scale on which "1" now means "falls short of your expectations" and "10" means "exceeds your expectations," to what extent has the VA Medical Center fallen short of or exceeded your expectations?
[RECORD NUMBER 1-10] DK REF
________________________________________________________________________
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Q13. Forget the VA Medical Center you recently visited for a moment. Now, I want you to imagine an ideal outpatient medical center. (PAUSE) How well do you think the VA Medical Center you recently visited compares with that ideal outpatient medical center? Please use a 10-point scale on which "1" means "not very close to the ideal," and "10" means "very close to the ideal."
[RECORD NUMBER 1-10] DK REF
________________________________________________________________________ Next, I want you to think about any communication you may have had over the past year with the VA Medical Center you recently visited regarding complaints about your experience.
Q14. Have you complained to that VA Medical Center within the past year?
1 Yes 2 No DK REF
________________________________________________________________________ {IF Q14 = 1 ASK Q14C-Q14D; OTHERWISE GO TO Q15}
Q14C. How well, or poorly, was your most recent complaint handled? Using a 10-point scale on which “1” means “handled very poorly” and “10” means “handled very well,” how would you rate the handling of your complaint?
[RECORD NUMBER 1-10] DK REF
________________________________________________________________________
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Q14D. How difficult or easy was it to make your most recent complaint? Using a 10-point scale on which “1” means “very difficult” and “10” means “very easy,” how difficult or easy was it to make a complaint?
[RECORD NUMBER 1-10] DK REF
________________________________________________________________________
Q15. How likely is it that you will use the VA Medical Center you recently visited again in the future when you need medical care? On a 10 point scale on which “1” means “very unlikely” and “10” means “very likely,” how likely is it that you will use that VA Medical Center again?
[RECORD NUMBER 1-10] DK REF
________________________________________________________________________
Q16. If asked, how willing would you be to say positive things about the VA Medical Center you recently visited to other veterans? On a 10 point scale on which “1” means “not at all willing” and “10” means “very willing,” how willing would you be to say positive things about that VA Medical Center?
[RECORD NUMBER 1-10] DK REF
________________________________________________________________________
Q17. Was your recent clinic visit scheduled or a “Walk-in”?
1 Scheduled 2 Walk-in
________________________________________________________________________
(If Q17 =2 ask Q18, otherwise skip to next section)
Q18. Was this clinic visit a “Walk-in” because of an emergency condition or illness?
1 Yes 2 No
______________________________________________________________ Now, we need to ask a few demographic questions for the ACSI consumer profile…
QD1. What is your age, please?
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[RECORD NUMBER OF YEARS 1-150] DK REF
________________________________________________________________________
QD2. What is the highest level of formal education you completed? (READ CODES 1-5)
3 Less than high school 4 High school graduate 5 Some college or associate degree 6 College graduate 7 Post-Graduate DK REF
________________________________________________________________________
QD3. Are you of Hispanic, Latino or Spanish origin?
1 Yes 2 No DK REF
________________________________________________________________________
QD4. Do you consider your race(s) as: (READ CODES 1-5; ACCEPT UP TO 5 MENTIONS)
1 White 2 Black/African American 3 American Indian/Alaska Native 4 Asian 5 Native Hawaiian or other Pacific Islander 6 Other race DK REF
________________________________________________________________________
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QD5. What was your total annual family income in 2013? (READ CODES 1-7 AS NECESSARY) (READ IF NECESSARY: Before taxes)
1 Under $20,000 2 $20,000 but less than $30,000 3 $30,000 but less than $40,000 4 $40,000 but less than $60,000 5 $60,000 but less than $80,000 6 $80,000 but less than $100,000 7 $100,000 or more DK REF
________________________________________________________________________
QD6. Gender (By Observation)
1 Male 2 Female
________________________________________________________________________
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APPENDIX B:SCORE TABLES
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Significant Differences – 2013 compared to 2012
Significant differences at the 90% level of confidence are note by an asterisk (*).
Sample SizeVeterans Medical Center 86 81 -5 *Accessibility of VA Medical Center 86 81 -5 *Pharmacy 71 73 2Waiting time to obtain prescriptions at the pharmacy 71 73 2Customer Service 93 91 -2Courteousness of appointment personnel 92 91 -1Courteousness of medical providers 94 92 -2Professionalism of medical providers 92 90 -2Customer Expectations 78 75 -3Expectations of the overall quality of the VA Medical Center 78 75 -3Quality 87 85 -2Overall quality of outpatient care at the VA Medical Center 87 85 -2Customer Satisfaction 82 82 0Overall satisfaction 86 85 -1Satisfaction compared to expectations 80 82 2Satisfaction compared to ideal 79 79 0Complaints 11 8 -3Complained to VA Medical Center within the past year 11 8 -3Loyalty 93 93 0Willingness to say positive things about the VA Medical Center 91 92 1Likelihood to use VA Medical Center in the future for medical care 96 95 -1Handling of Complaint 46 24 -22 *Handling of complaint 46 24 -22 *Ease of Making Complaint 62 46 -16Ease of making complaint 62 46 -16
Significant Difference
20132422012
241Difference
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History of scores from 2004-2013
2004 2005 2006Sample Size 254 254 256Veterans Medical Center 81 79 83 82 80 84 80 82 86 81Accessibility of VA Medical Center 81 79 83 82 80 84 80 82 86 81Pharmacy 74 74 72 74 74 75 74 74 71 73Waiting time to obtain prescriptions at the pharmacy 74 74 72 74 74 75 74 74 71 73Customer Service 91 89 90 92 91 91 91 92 93 91Courteousness of appointment personnel 90 88 89 92 90 92 90 92 92 91Courteousness of medical providers 92 90 92 94 93 92 93 92 94 92Professionalism of medical providers 90 88 89 90 90 90 90 90 92 90Customer Expectations 78 75 75 78 75 79 77 76 78 75Expectations of the overall quality of the VA Medical Center 78 75 75 78 75 79 77 76 78 75Quality 86 84 85 87 85 87 86 87 87 85Overall quality of outpatient care at the VA Medical Center 86 84 85 87 85 87 86 87 87 85Customer Satisfaction 83 80 82 83 81 83 82 83 82 82Overall satisfaction 86 84 86 87 84 86 85 86 86 85Satisfaction compared to expectations 80 78 79 81 78 81 80 82 80 82Satisfaction compared to ideal 81 77 81 80 79 82 79 81 79 79Complaints 15 13 15 17 17 14 14 10 11 8Complained to VA Medical Center within the past year 15 13 15 17 17 14 14 10 11 8Loyalty 92 90 92 92 91 92 90 92 93 93Willingness to say positive things about the VA Medical Center 91 89 91 91 90 90 89 91 91 92Likelihood to use VA Medical Center in the future for medical care 94 92 94 93 93 94 92 93 96 95Non-modeled questions 53 59 57 47 56 46 24Handling of complaint -- -- -- 53 59 57 47 56 46 24Ease of making complaint -- -- -- 65 75 74 55 64 62 46
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Complained compared to did not complain
Significant differences at the 90% level of confidence are note by an asterisk (*).
Sample SizeVeterans Medical Center 83 55 -28 *Accessibility of VA Medical Center 83 55 -28 *Pharmacy 76 47 -29 *Waiting time to obtain prescriptions at the pharmacy 76 47 -29 *Customer Service 93 73 -20 *Courteousness of appointment personnel 93 70 -23 *Courteousness of medical providers 94 77 -17 *Professionalism of medical providers 92 73 -19 *Customer Expectations 75 67 -8Expectations of the overall quality of the VA Medical Center 75 67 -8Quality 87 63 -24 *Overall quality of outpatient care at the VA Medical Center 87 63 -24 *Customer Satisfaction 85 54 -31 *Overall satisfaction 87 55 -32 *Satisfaction compared to expectations 84 55 -29 *Satisfaction compared to ideal 82 53 -29 *Complaints 0 100 100Complained to VA Medical Center within the past year 0 100 100Loyalty 95 75 -20 *Willingness to say positive things about the VA Medical Center 94 65 -29 *Likelihood to use VA Medical Center in the future for medical care 96 86 -10Handling of Complaint -- 24 --Handling of complaint -- 24 --Ease of Making Complaint -- 46 --Ease of making complaint -- 46 --
Significant Difference
Complained
221
Did not complain
20
Difference
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APPENDIX C: FREQUENCIES OF SURVEY QUESTIONS
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overallx Expectations of the overall quality of the VA Medical Center
Frequency Percent Valid Percent Cumulative
Percent
Valid
1.00 Not Very High 4 1.7 1.7 1.7
2.00 3 1.2 1.3 3.0
3.00 1 .4 .4 3.5
4.00 10 4.1 4.3 7.8
5.00 30 12.4 13.0 20.8
6.00 13 5.4 5.6 26.4
7.00 18 7.5 7.8 34.2
8.00 63 26.1 27.3 61.5
9.00 16 6.6 6.9 68.4
10.00 Very High 73 30.3 31.6 100.0
Total 231 95.9 100.0 Missing -98.00 10 4.1 Total 241 100.0
v_access Accessibility of VA Medical Center
Frequency Percent Valid Percent Cumulative
Percent
Valid
1.00 Very Inaccessible and
Difficult to Use 4 1.7 1.7 1.7
2.00 2 .8 .8 2.5
3.00 5 2.1 2.1 4.6
4.00 7 2.9 2.9 7.5
5.00 19 7.9 7.9 15.4
6.00 11 4.6 4.6 20.0
7.00 13 5.4 5.4 25.4
8.00 41 17.0 17.1 42.5
9.00 26 10.8 10.8 53.3
10.00 Very Accessible and
Easy to Use 112 46.5 46.7 100.0
Total 240 99.6 100.0 Missing -98.00 1 .4 Total 241 100.0
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cs_app Courteousness of appointment personnel
Frequency Percent Valid Percent Cumulative
Percent
Valid
1.00 Not At All Courteous 2 .8 .8 .8
2.00 1 .4 .4 1.2
3.00 3 1.2 1.2 2.5
4.00 1 .4 .4 2.9
5.00 5 2.1 2.1 5.0
6.00 4 1.7 1.7 6.6
7.00 6 2.5 2.5 9.1
8.00 28 11.6 11.6 20.7
9.00 24 10.0 10.0 30.7
10.00 Very Courteous 167 69.3 69.3 100.0
Total 241 100.0 100.0
cs_pro Courteousness of medical providers
Frequency Percent Valid Percent Cumulative
Percent
Valid
1.00 Not At All Courteous 2 .8 .8 .8
3.00 3 1.2 1.3 2.1
4.00 2 .8 .8 2.9
5.00 5 2.1 2.1 5.0
6.00 2 .8 .8 5.9
7.00 6 2.5 2.5 8.4
8.00 14 5.8 5.9 14.2
9.00 34 14.1 14.2 28.5
10.00 Very Courteous 171 71.0 71.5 100.0
Total 239 99.2 100.0 Missing -98.00 2 .8 Total 241 100.0
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cs_prof Professionalism of medical providers
Frequency Percent Valid Percent Cumulative
Percent
Valid
1.00 Not At All Professional 3 1.2 1.3 1.3
2.00 2 .8 .8 2.1
3.00 2 .8 .8 3.0
4.00 1 .4 .4 3.4
5.00 7 2.9 3.0 6.3
6.00 4 1.7 1.7 8.0
7.00 7 2.9 3.0 11.0
8.00 22 9.1 9.3 20.3
9.00 31 12.9 13.1 33.3
10.00 Very Professional 158 65.6 66.7 100.0
Total 237 98.3 100.0
Missing
-99.00 1 .4 -98.00 3 1.2 Total 4 1.7
Total 241 100.0
p_wait Waiting time to obtain prescriptions at the pharmacy
Frequency Percent Valid Percent Cumulative
Percent
Valid
1.00 Very Slow 5 2.1 3.5 3.5
2.00 2 .8 1.4 5.0
4.00 5 2.1 3.5 8.5
5.00 14 5.8 9.9 18.4
6.00 13 5.4 9.2 27.7
7.00 17 7.1 12.1 39.7
8.00 29 12.0 20.6 60.3
9.00 17 7.1 12.1 72.3
10.00 Very Fast 39 16.2 27.7 100.0
Total 141 58.5 100.0
Missing
-98.00 2 .8 -11.00 98 40.7 Total 100 41.5
Total 241 100.0
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overallq Overall quality of outpatient care at the VA Medical Center
Frequency Percent Valid Percent Cumulative
Percent
Valid
1.00 Not Very High 4 1.7 1.7 1.7
3.00 3 1.2 1.3 2.9
4.00 1 .4 .4 3.3
5.00 10 4.1 4.2 7.5
6.00 2 .8 .8 8.3
7.00 21 8.7 8.8 17.1
8.00 46 19.1 19.2 36.3
9.00 43 17.8 17.9 54.2
10.00 Very High 110 45.6 45.8 100.0
Total 240 99.6 100.0 Missing -98.00 1 .4 Total 241 100.0
satis Overall satisfaction
Frequency Percent Valid Percent Cumulative
Percent
Valid
1.00 Very Dissatisfied 4 1.7 1.7 1.7
2.00 2 .8 .8 2.5
3.00 1 .4 .4 2.9
4.00 2 .8 .8 3.8
5.00 9 3.7 3.8 7.5
6.00 5 2.1 2.1 9.6
7.00 23 9.5 9.6 19.2
8.00 39 16.2 16.3 35.6
9.00 44 18.3 18.4 54.0
10.00 Very Satisfied 110 45.6 46.0 100.0
Total 239 99.2 100.0
Missing
-99.00 1 .4 -98.00 1 .4 Total 2 .8
Total 241 100.0
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confirm Satisfaction compared to expectations
Frequency Percent Valid Percent Cumulative
Percent
Valid
1.00 Falls Short of Your
Expectations 6 2.5 2.5 2.5
3.00 1 .4 .4 2.9
4.00 5 2.1 2.1 5.0
5.00 13 5.4 5.4 10.4
6.00 10 4.1 4.2 14.6
7.00 23 9.5 9.6 24.2
8.00 51 21.2 21.3 45.4
9.00 31 12.9 12.9 58.3
10.00 Exceeds Your
Expectations 100 41.5 41.7 100.0
Total 240 99.6 100.0 Missing -98.00 1 .4 Total 241 100.0
ideal Satisfaction compared to ideal
Frequency Percent Valid Percent Cumulative
Percent
Valid
1.00 Not Very Close to the
Ideal 5 2.1 2.1 2.1
2.00 5 2.1 2.1 4.2
3.00 5 2.1 2.1 6.3
4.00 2 .8 .8 7.2
5.00 13 5.4 5.5 12.7
6.00 12 5.0 5.1 17.7
7.00 25 10.4 10.5 28.3
8.00 45 18.7 19.0 47.3
9.00 28 11.6 11.8 59.1
10.00 Very Close to the
Ideal 97 40.2 40.9 100.0
Total 237 98.3 100.0 Missing -98.00 4 1.7 Total 241 100.0
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handle Handling of complaint
Frequency Percent Valid Percent Cumulative
Percent
Valid
1.00 Handled Very Poorly 8 3.3 40.0 40.0
2.00 5 2.1 25.0 65.0
4.00 3 1.2 15.0 80.0
7.00 1 .4 5.0 85.0
8.00 2 .8 10.0 95.0
10.00 Handled Very Well 1 .4 5.0 100.0
Total 20 8.3 100.0 Missing -80.00 221 91.7 Total 241 100.0
c_ease Ease of making complaint
Frequency Percent Valid Percent Cumulative
Percent
Valid
1.00 Very Difficult 4 1.7 21.1 21.1
2.00 1 .4 5.3 26.3
3.00 2 .8 10.5 36.8
4.00 1 .4 5.3 42.1
5.00 3 1.2 15.8 57.9
7.00 3 1.2 15.8 73.7
8.00 2 .8 10.5 84.2
10.00 Very Easy 3 1.2 15.8 100.0
Total 19 7.9 100.0
Missing
-98.00 1 .4 -80.00 221 91.7 Total 222 92.1
Total 241 100.0
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repur Likelihood to use VA Medical Center in the future for medical care
Frequency Percent Valid Percent Cumulative
Percent
Valid
1.00 Very Unlikely 4 1.7 1.7 1.7
2.00 1 .4 .4 2.1
4.00 2 .8 .8 2.9
5.00 4 1.7 1.7 4.6
6.00 1 .4 .4 5.0
7.00 1 .4 .4 5.4
8.00 7 2.9 2.9 8.3
9.00 17 7.1 7.1 15.4
10.00 Very Likely 203 84.2 84.6 100.0
Total 240 99.6 100.0 Missing -98.00 1 .4 Total 241 100.0
advocacy Willingness to say positive things about the VA Medical Center
Frequency Percent Valid Percent Cumulative
Percent
Valid
1.00 Not At All Willing 4 1.7 1.7 1.7
2.00 1 .4 .4 2.1
3.00 3 1.2 1.3 3.3
4.00 1 .4 .4 3.8
5.00 5 2.1 2.1 5.8
6.00 4 1.7 1.7 7.5
7.00 5 2.1 2.1 9.6
8.00 19 7.9 7.9 17.5
9.00 17 7.1 7.1 24.6
10.00 Very Willing 181 75.1 75.4 100.0
Total 240 99.6 100.0 Missing -98.00 1 .4 Total 241 100.0
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APPENDIX D: DISPOSITION REPORT
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ACSI Code Definition n
U UNIVERSE OF SAMPLED TELEPHONE NUMBERS 1188
InterviewsI Total completed interviews 250P Partial interviews 2I+P Total interviews 252
Eligible cases that are not interviewed (Non-respondents)Break-offs 0Refusal, qualified cases 9
RQ Total qualified cases refusals 9
Cases of unknown eligibility (Unknown eligibility/No contact—Non-interview)Refusal before screening for eligible respondent 38No answer/Not available 314Answering machine/voice mail 447Busy 1Foreign language/hard of hearing 16
UE Total unknown eligibility 816
Cases that are not eligible (Non-eligible Respondents)Disconnect/out of service 103Computer/FAX 1Wrong number 3Filter 4Other Non-eligible respondent
NER Total Non-eligible Respondents 111
Quota Filled so respondent not eligible for interviewCase of quota-filled subgroup 0Scheduled for callback, but subgroup quota filled or interview period ended 0
QF Total Quota Filled Respondents 0
U Universe of Sampled Numbers 1188
NER Less Non-eligible Respondents 111
QF Less Quota Filled Respondents 0
EU Universe of Eligible Numbers 1077
COOPERATION RATE (AAPOR (2)) = I/(I+P)+RQ 95.8%e = (I+P+RQ+QF)/(I+P+RQ+QF+NER) 70.2%
RESPONSE RATE (AAPOR RR(3)) = I+COOP(QF)/(I+P+RQ+QF+NER+e(UE)) 26.5%