Patient-centered care: factors associated with reporting a positive experience at United States fertility clinics

Objective: To determine factors associated with a positive patient experience (PPE) at fertility clinics. Design: Cross-sectional study. Setting: Not applicable. Patient(s): Female respondents to the FertilityIQ questionnaire (www.fertilityiq.com) reviewing the first or only U.S. clinic visited from July 2015 to July 2018. Intervention(s): None. Main Outcome Measure(s): PPE was defined as a score of 9 or 10 out of 10 on the question, “Would you recommend this fertility clinic to a best friend?” Examined predictors included demographics, payment details, infertility diagnoses and treatment, physician traits, and clinic operations and resources. Multiple imputation was used for missing variables. Logistic regression was used to calculate adjusted odds ratios for factors associated with PPE. Result(s): Of the 7,456 women included, 63.1% reported PPE. Pregnancy resulting from treatment was a predictor of PPE. In multivariable analysis, the strongest predictors of PPE were related to the patient-physician relationship (“feeling treated like a human rather than a number” and having a doctor with good communication skills and who set reasonable expectations). Multiple clinic-related factors were also independently associated with PPE, including satisfaction with billing, shorter wait times, and easy appointment scheduling. Conclusion(s): While pregnancy influences patients’ views of their fertility clinic experience, there are other modifiable patient, physician, and clinic factors associated with PPE. Clinics may be able to optimize patient experience and improve the quality of care that they provide by being cognizant of such factors.