Introduction

This chapter provides a critical review of the literature on patient reports and evaluations of interpersonal aspects of cancer care as indicators of the quality of cancer care, which we will call “the patient's perspective.” The rationale for placing the patient at the center of efforts to assess the quality of health care is well established: policy makers, health care providers, purchasers of care, and researchers are interested in what patients think. For example, the National Health Care Quality Report, to be published in 2003, will include the consumer's perspective as a key indicator of health care quality.

Donabedian stated that “achieving and producing health and satisfaction, as defined for its individual members by a particular society or subculture is the ultimate validator of the quality of care.” He saw that the patient's greatest contribution to measuring health care quality is assessing the interpersonal aspects of care.

The specific justifications for the interest in the patient's perspective have changed somewhat over time. Originally, they were based on evidence that patients who are satisfied are more likely to comply with treatment regimens, provide relevant information to the health care provider, and return for care.– Thus, measuring the patient's perspective, particularly satisfaction, may be important to the health care provider from the standpoint of keeping the patient as a customer, because satisfied patients are more likely to stay with their doctors. Patients who changed doctors say that the doctor's style and personality were the main reasons.