Organizational determinants of patient-centered fertility care: a multilevel analysis

OBJECTIVE: To identify organizational determinants of positive patient experiences with fertility care, with the goal of improving patient centeredness of care. DESIGN: Cross-sectional survey. SETTING: One large university clinic and 12 medium-sized fertility clinics in the Netherlands. PATIENT(S): Three hundred and sixty-nine couples receiving medically assisted reproduction in one of the participating clinics between March and May 2008. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Organizational determinants of patients' experiences with patient centeredness in fertility care. RESULT(S): Of the patients during the relevant period, 78% of the women and 76% of their partners participated in the study. Infertile couples who have a lead physician, have access to an electronic personal health record, or see trained fertility nurses have more positive experiences with aspects of patient-centered care, like continuity of care and partner involvement. Moreover, receiving a treatment other than in vitro fertilization was negatively associated with the perceived patient centeredness of care. The identified determinants explained 5.1% to 22.4% of the total variance. CONCLUSION(S): This study provides organizational determinants of patients' experiences with fertility care on numerous facets of patient centeredness. These organizational determinants can be used as valuable tools to enable clinics to provide a more positive patient experience