Introduction: High-quality doctor-patient relationship is a worldwide concern for medicine, particularly with regard to medical education. Objective: This research aimed to carry out a needs assessment in order to identify targets for improving the doctor-patient relationship teaching and learning process in the undergraduate Medicine course at the Sergipe Federal University (UFS). Methods: A narrative review of cognitive behavior perspective, an integrative review of the Brazilian literature and a cross-sectional descriptive study were done. This study involved 165 undergraduate Medicine students at the UFS (92 women and 73 men), 31 professors (11 women and 20 men) and 71 patients (59 women and 12 men) admitted at the university hospital. The instruments applied included: a Brazilian version of the Patient-Practitioner Orientation Scale (PPOS), which is a self-evaluation scale consisting of 18 items; a demographic questionnaire and three versions of a questionnaire on doctor-patient relationship with open and closed-ended questions. The first version consisted of 14 items and was designed for the students; the second version consisted of 15 questions and was designed for the professors; and the third version consisted of seven questions and was designed for the patients. Both the curriculum and the syllabus of the Medicine course were analyzed. Results: Review outcomes indicated a growing interest in the topic, with observational research and experience reports, but lacking evaluation tools. Field research showed that interpersonal development in medical education is considered important for 93.5% of professors and 95.7% of students. However, only two disciplines explicitly describe such content in their syllabus. The most common strategies applied by professors were rule-based learning (41.7%), modelling (33.3%) and shaping (19.4%). The major obstacles identified were curriculum flaws (52.7%), professors flaws (20.6%) or students difficulties (14.6%). Self-control and emotional expressiveness, communication, civility and empathy were classes of social skills indicated as important by more than 80% of each of the participating groups. Physician-centered attitudes were indicated by 45.2% of professors, 56.4% of students and 88.7% of patients. The professors total PPOS mean score was the highest (4.66 ± 0.52), suggesting a mildly patient-focused attitude. The students total PPOS mean score (4.43 ± 0.53) was higher than that of the patients (3.93 ± 0.59), but both indicated patient-centered attitude. Conclusion: It is understood that the doctor-patient relationship is yet to be included in formal medical school planning. Also, such content has not been continuously developed and specific strategies for teaching interpersonal skills are barely applied. However, the respondents in this study acknowledged the importance of interpersonal development in medical education, which supports its inclusion in formal education, as well as the inclusion of new teaching strategies. Such acknowledgement may trigger discussions on educational planning and social skills training, as long as professors, students and patients demands are taken into account. / Introdução: No cenário mundial a relação médico-paciente de qualidade é uma das preocupações da Medicina, particularmente no que diz respeito à educação médica. Objetivo: O objetivo desta pesquisa foi fazer uma avaliação de necessidades com vistas a identificar alvos para a melhoria do ensino e a aprendizagem da relação médico-paciente no curso de graduação de Medicina da Universidade Federal de Sergipe (UFS). Métodos: Foram feitas: uma revisão narrativa da perspectiva cognitivo-comportamental, uma revisão integrativa da literatura nacional e uma pesquisa descritiva transversal. Participaram do estudo 165 alunos do curso de graduação de Medicina da UFS (92 mulheres e 73 homens), 31 professores (11 mulheres e 20 homens) e 71 pacientes (59 mulheres e 12 homens) atendidos no hospital universitário. Os instrumentos utilizados foram: a versão brasileira do Patient-practitioner Orientation Scale (PPOS), que é uma escala autoinforme com 18 itens, um questionário de dados demográficos e três versões de um questionário sobre a relação médico-paciente com perguntas abertas e fechadas. A primeira versão era composta por 14 itens e foi aplicada com os estudantes, a segunda versão era composta por 15 questões e foi aplicada com os professores e a terceira versão era composta por sete questões e foi aplicada com os pacientes. Foi feita uma análise do currículo e das ementas do curso de Medicina. Resultados: Os resultados da revisão apontaram um crescente interesse na temática com pesquisas observacionais e relatos de experiência, mas com falta de instrumento de avaliação. Os resultados da pesquisa de campo apontaram que o desenvolvimento interpessoal na educação médica é considerado importante para 93,5% dos professores e 95,7% dos alunos, mas apenas duas disciplinas têm como objetivo explícito em suas ementas esse conteúdo. As principais estratégias utilizadas pelos professores foram aprendizagem por regras (41,7%), modelação (33,3%) e modelagem (19,4%). As principais barreiras apontadas foram falhas da estrutura curricular (52,7%), déficits do professor (20,6%) ou dificuldades dos próprios alunos (14,6%). O autocontrole e expressividade emocional, comunicação, civilidade e empatia foram as classes de habilidades socais indicadas como importante por mais de 80% de cada um dos grupos participantes. As atitudes centradas no médico foram indicadas por 45,2% dos professores, 56,4% dos alunos e 88,7% dos pacientes. A média do escore total do PPOS dos professores foi a mais alta (4,66±0,52), sugerindo atitude mediamente centrada no paciente. A média do escore total do PPOS dos alunos (4,43±0,53) foi mais alta que dos pacientes (3,93±0,59), porém ambas indicaram atitude centrada no paciente. Conclusão: Entende-se que a relação médico-paciente ainda não está incluída no planejamento formal do curso de Medicina, que este conteúdo não tem sido desenvolvido de forma contínua e que o uso de estratégias de ensino específicas para habilidades interpessoais é restrito. Porém, há uma credibilidade da importância do desenvolvimento interpessoal na educação médica pelos respondentes, o que favorece a formalização de seu ensino e a inclusão de novas estratégias didáticas. Esta identificação pode promover discussões sobre o planejamento educacional, bem como a reflexão sobre o treinamento de habilidades sociais levando em consideração as demandas dos professores, estudantes e pacientes.

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L’être humain est de plus en plus souvent inscrit dans des contextes où lui est accessible un savoir nouveau sur sa vie biologique (e.g., gènes, épigénome, neurones, microbiote). À portées de mains ou de clics, des médiations toujours plus nombreuses (e.g. tests génétiques prédictifs en matière de santé ; « récréatifs », relatifs à l’« ancestralité biogéographique », microbiote intestinal ou à l’« âge épigénétique » ; applications dites de « self-tracking ») mettent l’usager en relation avec des formats d’information de plus en plus diversifiés (e.g., SNP’s, diagnostics, probabilités exprimées sous forme de pourcentages de développer des maladies ou d’autres conditions : réponses de l’organisme à certains pathogènes et molécules, résistance à certaines pathologie, et d’autres propriétés qui seraient influencées par la génétique, comme la longévité ou les facultés cognitives). La découverte de ces données biologiques éprouve la personne et la confronte à de nouvelles inquiétudes qu’elle doit traverser.Menée sur base de trois terrains situés dans le champ de la santé (consultation médicale, usage du web en matière de santé, et usage d’auto-tests tests génétiques), cette recherche contribue à la compréhension de ce phénomène de société. Elle s’applique en particulier à préciser la variété des façons dont la personne intègre ces données nouvelles qui s’accompagnent d’une prétention à un réalisme fort. Dans certains cas, ces technologies fournissent à l’individu une image objectivante de son « identité ». L’approche préconisée s’articule à un questionnement anthropologique singulier : Comment la personne s’arrange-t-elle de situations dans lesquelles elle est mise en relation non plus seulement avec d’autres humains mais au premier titre avec des données objectivantes relatives à son intériorité biologique ? Cette question anthropologique invite à porter au moins autant d’attention à ce qui nous relie à autrui et à notre environnement (deux questions classiquement situées au cœur du projet de la sociologie), qu’aux façons dont l’humain assure une continuité avec lui- même dans des situations où le vivant pose question. Cette recherche démontre que la conduite effectivement adoptée par les usagers des trois médiations examinées est irréductible à l’attente d’autonomie souvent promue comme prise en charge de sa santé relevant d’un plan d’action orienté vers un but à atteindre. Soutenue par des outils sociologiques qui sous-tendent une conception plurielle du sujet et de l’action, cette recherche attire l’attention sur des dynamiques peu traitées dans les sciences sociales de la santé. L’examen attentif du maintien du sujet mis à l’épreuve de ces nouveaux savoirs jette une lumière nouvelle sur l’habileté de l’humain à évoluer entre une pluralité de positions, de définitions de ce qu’il se passe et/ou de qui il est afin de s’arranger de ces découvertes qui insécurisent son état de sujet. Plutôt que de considérer le caractère ambivalent, équivoque et parfois carrément ambigu de la conduite de l’usager comme un échec de l’analyse, ce travail contribue à une approche de la composition dans le rapport à soi et à autrui. / More than ever before humans have access to new knowledge about their biological life (e.g., genes, biochemical marks influencing phenotypes, neurons, microbiota). This knowledge is progressively transfered out of laboratories and into commercial markets. Then, by means of an ever-increasing number of readily available mediations (e.g. direct-to-consumer (epi)genomic tests (DTC GT), health-related uses of the Internet, direct-to-consumer genomic tests, self-tracking applications on smartphones) layusers are connected to an increasingly diverse array of data (e.g., online diagnostics, genomic predispositions, probabilities, SNP’s). My doctoral thesis develops an investigation of the practices whereby individuals ensure continuity with others/themselves when confronted to new knowledge related to their biology. Knowing the so-called “real” or potential biological endowment of oneself but also of others has tremendous social, political and ethical consequences. These new reflexive technologies grant individuals with an objectifying image of their “identity”. These new objectifying data related to the biological self puts the subject to test. They confront them to inquietudes they have to cope with.Built on three fieldworks located in the field of health (the classic medical examination, health-related information on the Internet, health-related direct-to-consumer genomic tests), this research fosters a better understanding of this social phenomenon. My investigation specifically seeks to clarify the variety of ways that allow individuals to integrate these new data marked with a strong degree of realism. The approach set forth in this research revolves on a specific anthropological question: how human beings find arrangements with situations in which they are not only confronted to others but also with objectifying data related to their biological life? This anthropological problematic invites us to bring at least as much attention to what connects us with others than to the specific ways individuals ensure continuity with themselves in contexts where the “living” raises question. My research demonstrates that the conduct actually adopted by users of the three mediations studied is irreducible to the expected liberal autonomy often promoted in the literature as “management of one’s health”. A careful analysis of the subject’s consistence facing this new knowledge highlights social dynamics that have received little attention in the field of social sciences of health. The fieldworks carried out provide new insights on the human ability to bring together different positions or definitions of what is happening and/or who you are in order to arrange with these discoveries that challenge their subject consistency. Rather than considering the equivocal features and sometimes the outright ambiguity of the conducts as a failure of the analysis, this research effort contributes achieving a better understanding of the pervasiveness of composition in our relationship to our self and the others in social contexts related to biology

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Britain's Asians are a young population and their socio-economic status is low, with racial disadvantage in housing, employment, education and health. Research on their health has usually not been conducted in its socio-economic and demographic context and there is little on their use of primary care. Three studies were conducted to investigate their relationship with primary care in Bradford. A study of general practice attenders of white/British, Pakistani and Indian origin confirmed the demographic and socio-economic differences between the groups. The former had higher rates of alcohol and cigarette consumption. For Pakistanis and Indians, fluency and literacy in English was poor. Ethnic and linguistic match between doctor and patient was more important in patients' choice of doctor than the doctor's sex. Differential employment status of Asian and white/British accounted for some of the differences in health. A study of general practice attendance showed similar rates of surgery consultations between Asians and Non-Asians; the latter made greater use of domiciliary services. Both these studies were conducted in an inner Bradford health centre with an Asian male, a white male and a white female doctor. Bradford GPs were found to perceive that Asian patients made greater use of surgery and domiciliary consultations; attended more often for trivial complaints; and had lower compliance rates than Non-Asians. These perceptions were not supported by objective data. Better qualified GPs had a smaller, and Asian doctors had a greater proportion of Asian patients on their lists. Research, and action on Asians' health, needs to take account of their poorer socio-economic status. / Yorkshire Regional and Bradford District Health Authority.

“Dysautonomia” or a dysfunction of the autonomic nervous system, affects approximately 70 million children and adults worldwide. Despite this, a small fraction of studies focus on the experiences of children and teenagers' living with conditions related to dysautonomia. The aim of this study is thus to explore the experiences and perspective of teenagers living with dysautonomia, by focusing on how they describe their lives in relation to being chronically ill and how they view the relationships among themselves, their doctors and their peers. The study entails a social constructionist and an interpretative phenomenological approach, which focuses on the lived experiences of the teenagers. To collect the data, an email questionnaire1 was conducted with 16 teenagers from different parts of the world. The data was analyzed with the help of a thematic analysis. Seven themes were identified under my areas of interest; a regular day, relationships with peers and relationships with doctors. The results indicated that dysautonomia, similar to other chronic illnesses, was reducing life quality. The results also indicated that most days were spent trying to distract themselves from their illnesses. The participants described feelings related to uncertainty, fear, loneliness and grief. Difficulties remaining socially active and maintaining friendships were described by some of the participants. Relationships with peers were described as both supportive and unsupportive and were often described in terms of healthy and sick peer groups. The doctor-patient relationship was described in terms of good and bad qualities. Although all participants described feeling dismissed, belittled and accused of making their symptoms and illnesses up in their heads, some also described the opposite - the good and respectful listener, who valued the autonomy of the participants.

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No description available.

In einer repräsentativen Querschnittsuntersuchung wurden 1219 Multiple Sklerose Betroffene in Deutschland zu den Auswirkungen der Multiple Sklerose auf deren Lebenssituation und ihrer Einschätzung der medizinischen Versorgung befragt. Schwerpunkte der Untersuchung, die auf einem integrativen Konzept der Patientenorientierung beruht, waren: Soziale Auswirkungen, Krankheitswahrnehmung, Alltagsbewältigung, Lebensqualität, Patienteninformation, Arzt-Patient-Beziehung, Therapieentscheidung und das ACT Programm in der medizinischen Versorgung. Negative Auswirkungen der Multiple Sklerose auf die untersuchten Lebensbereiche sind nachweisbar, aber die Einschätzung differiert in Abhängigkeit von der konkreten Lebenssituation und der Persönlichkeit. Der Schweregrad der körperlichen Einschränkungen steht nur bedingt in Beziehung zur subjektiven Einschätzung der Auswirkungen. Es bestätigt sich außerdem die besondere Bedeutung des nahen persönlichen Umfeldes als wichtigste Quelle der Unterstützung Multiple Sklerose Betroffener. Professionelle Unterstützung wird nur in geringem Maß in Anspruch genommen. Die Anforderungen der Befragten an die medizinische Versorgung sind sehr hoch. Negative Bewertungen der medizinischen Betreuung zeigen sich sowohl bei kritischeren Befragten und als auch bei ausgeprägten Autonomiebedürfnis. Die befragten Multiple Sklerose Betroffenen nutzen überwiegend objektive Informationsquellen als allgemeine Informationsbasis und zur Therapieentscheidung. Subjektives Erfahrungswissen wird meist nur ergänzend herangezogen. Veränderungsbedarf besteht in der medizinischen Versorgung im Bezug auf die Integration kritischerer, informierterer, selbstbewussterer Multiple Sklerose Betroffene und in Bezug auf den Zugang zu den vorhandenen Informations-, Unterstützungs- und Beratungsangeboten. / In a representative study 1219 people with multiple sclerosis in Germany were asked about the impacts of multiple sclerosis on their living situation and their estimation of the medical supply. Main topics were: social impacts, perception of the disease, coping with everyday life, quality of life, patient information, doctor-patient-relationship, shared decision making and the ACT programme as tool in the medical supply. Negative impacts on all analysed areas of the living situation could be proved, but the estimation differs in dependence on the specific living situation and the personality. Unlike the physical disability isn''t a predictor of the individual estimation of the impact. People with multiple sclerosis get their main support by relatives and friends. Professional services are rarely used in relation to the aid by the individual social environment. People with multiple sclerosis have very high expectations on the medical supply. The estimation of the situation is relatively negative if the people are more critical as well as if they have a great need for autonomy. The interrogated people with multiple sclerosis use basically and for their therapy decision mostly objective, medical information. Most of them use subjective knowledge based on experiences only additionally. Medical supply should be optimised by better integrating people with multiple sclerosis who are more critical or self confident as well as better informed. Usability and access of the existing offers to inform, support and counsel people with multiple sclerosis have to be improved.

Knie- und Hüftgelenkersatz zählt weltweit zu den erfolgreichsten und häufigsten Operationen, wenngleich 3-24% der Patienten unzufrieden sind. Der OECD-Ländervergleich ergab 2014 für Deutschland die höchste Durchführungsrate an Hüft-TEP und die zweithöchste an Knie-TEP. Erhebungen der Patientenzufriedenheit und Rückkehrbereitschaft können zur Prozessoptimierung und Qualitätsverbesserung genutzt werden und zugleich eine Steigerung der Zufriedenheit und Kundenbindung fördern. Mit der erstmaligen Aufnahme eines P4P-Ansatzes im KHSG, sind zukünftig qualitätsbezogene Zuschlagszahlungen an ein Krankenhaus unter Berücksichtigung der Patientenzufriedenheit denkbar. Damit gewinnen Erwartungen der Patienten an ein Krankenhaus zunehmend an Bedeutung, da deren Erfüllung Einfluss auf die Erlösrechnung haben kann. Parallel kann eine Anpassung der Versorgungsstruktur dazu führen, dass verstärkt Behandlungszentren entstehen und operative Eingriffe bei geringer Fallzahl in abgeschiedenen, ländlichen Regionen nicht mehr erbracht werden. Diese Studie befasste sich mit medizinischen und servicebezogenen Parametern sowie Krankenhausdaten, die signifikant mit der Zufriedenheit bei Patienten nach Knie- und Hüft-TEP assoziiert waren und die Bereitschaft in dasselbe Krankenhaus zurückzukehren beeinflussen. Neben der Frage, ob unterschiedliche Parameter Einfluss auf die Gesamtzufriedenheit und Rückkehrbereitschaft haben, wurde untersucht, inwiefern potentielle Einflussgrößen zwischen Knie- und Hüft-TEP-Patienten variieren. Zudem wurde die Relevanz verschiedener Kriterien erhoben, die aus Patientensicht Einfluss auf die Wahl eines zukünftigen Krankenhausaufenthalts haben kann. Die Daten der Studie wurden über eine schriftliche Befragung von Knie- und Hüft-TEP-Patienten gewonnen, die zwischen 2010 und 2011 in sächsischen Krankenhäusern in den Direktionsbezirken Dresden und Chemnitz behandelt wurden. Zufriedenheit und Rückkehrbereitschaft waren jeweils abhängige Variablen in mehreren logistischen Regressionsanalysen. Gemeinsam mit den unabhängigen Variablen wurden diese über einen validierten, mehrdimensionalen Fragebogen anhand 6-stufiger Skalen abgefragt und zusammen mit Routinedaten der Krankenhäuser bivariat und multivariat ausgewertet. Die Krankenhausdaten wurden den strukturierten Qualitätsberichten der Krankenhäuser entnommen. In die Analyse wurden 856 Fragebögen von Knie-TEP-Patienten und 810 Fragebögen von Hüft-TEP-Patienten eingeschlossen, was einer Rücklaufquote von 12,04% bzw. 11,89% entsprach. Bei beiden Behandlungsgruppen war im Ergebnis der multivariaten Analyse das subjektive Behandlungsergebnis sowohl mit der Gesamtzufriedenheit als auch mit der Rückkehrbereitschaft assoziiert. Postoperative Komplikationen waren jeweils nur mit der Rückkehrbereitschaft verknüpft. Einfluss auf die Rückkehrbereitschaft hatte bei Knie-TEP-Patienten zudem die Freundlichkeit des Pflegepersonals, die Organisation und der Ablauf von Untersuchungen sowie die Zimmerausstattung. Letztere wies zusammen mit der Qualität des Essens einen Zusammenhang zur Gesamtzufriedenheit bei dieser Patientengruppe auf. Bei den Hüft-TEP-Patienten war die Einschätzung der Aufenthaltsdauer, die verständliche Beantwortung von Patientenfragen durch Ärzte, die Sauberkeit und die verständliche Aufklärung über die Operation sowie die Wahrung der Privatsphäre bei Untersuchungen auch mit der Rückkehrbereitschaft assoziiert. Ein weiterer Zusammenhang zur Gesamtzufriedenheit zeigte sich dagegen bei der Einschätzung der ärztlichen Betreuung und der Einschätzung der Aufenthaltsdauer für Hüft-TEP-Patienten. Den Krankenhausparametern Behandlungsfallzahl, postoperative Beweglichkeit und Reoperation lag kein Zusammenhang gegenüber den abhängigen Variablen zugrunde. Die Befragten beider Behandlungsgruppen gaben gleichermaßen an, dass die Qualität der Behandlung bei der zukünftigen Wahl eines Krankenhauses am wichtigsten ist. Demgegenüber waren die Entfernung der Klinik zum Wohnort sowie die Größe des Krankenhauses im unteren Bereich der Bewertung angesiedelt. Es konnten verschiedene Interventionsmaßnahmen aufgezeigt werden, die auf der Makro-, Meso- und Mikroebene einzuordnen waren und in ihren Auswirkungen den einzelnen Patienten ebenso wie Entscheidungsträger im Gesundheitswesen ansprechen. Die relevanten Einflussfaktoren aus Patientensicht zeigten, dass Zufriedenheit und Rückkehrbereitschaft differenziert bewertet werden und auch zwischen Knie- und Hüft-TEP-Patienten variieren. Die Ergebnisse liefern krankenhausübergreifend wertvolle Informationen und unterstützen das medizinische Fachpersonal, Erwartungen von Knie- und Hüft-TEP-Patienten gerecht zu werden, die sich unter anderem auf die Bereiche Personalentwicklung, Patientenaufklärung und Catering erstreckten. Patientenzufriedenheit kann sich auf die Compliance auswirken, womit ein verbessertes Behandlungsergebnis erreicht werden kann. Infolge einer gezielten Steigerung der Patientenzufriedenheit sind Einsparungen durch eine kürzere Krankenhausverweildauer oder seltenere Komplikationen denkbar. Somit konnte die Präsenz der Patientenzufriedenheit im Rahmen aktueller DRG-Abrechnungsverfahren und zukünftig unter Berücksichtigung des P4P-Ansatzes aufgezeigt werden, die neben einer Erlössteigerung für das einzelne Krankenhaus zugleich Einsparungen auf der Gesundheitssystemebene bewirken kann. In Betracht an den im Aufbau befindlichen P4P-Ansatz, können die Ergebnisse als Grundlage dienen, um die Wirksamkeit der Patientenzufriedenheit als einem von vier möglichen Leistungszielen statistisch auf deren Wirksamkeit zu überprüfen. Die Bewertung verschiedener Parameter bei der zukünftigen Wahl eines Krankenhauses deutet darauf hin, dass sich weitere Anfahrtswege infolge der im Wandel befindlichen Versorgungsstruktur aus Patientensicht nicht nachteilig auswirken werden. / Knee and hip joint replacements are among the most successful and frequent operations conducted worldwide, with 3-24% of all patients being dissatisfied. In 2014, an OECD country comparison showed that Germany had the highest implementation rate for total hip replacement and the second highest for total knee replacement. Surveys of patient satisfaction and willingness to return can be used to optimize processes and improve quality while at the same time encouraging an increase in satisfaction and customer loyalty. With the first-time inclusion of a P4P approach in the German Hospital Structures Act (Krankenhausstrukturgesetz (KHSG)), quality-related supplementary payments to a hospital may be feasible in the future, taking patient satisfaction into account. In this way, patients' expectations of a hospital increasingly gain in importance, since their fulfilment can have an impact on the revenue calculation. At the same time, an adjustment of the care structure may lead to the increasing emergence of treatment centers and that surgical intervention will no longer be provided in isolated, rural regions with a sparse number of cases. This study looked at medical and services-related parameters as well as hospital data significantly associated with satisfaction in patients after total knee and hip endoprosthesis and affecting their willingness to return to the same hospital. In addition to the question whether different parameters have an influence on the overall satisfaction and willingness to return, the extent was examined to which potential influencing variables vary between the total knee and hip endoprosthesis patients. In addition, the relevance of different criteria was assessed, which from the view of a patient may have an influence on the choice of a future hospital stay. The data of the study were obtained through a written survey of total knee and hip endoprosthesis patients treated between 2010 and 2011 in Saxon hospitals of the directorate districts of Dresden and Chemnitz. In several logistic regression analyses, the dependent variables were satisfaction and returnability, respectively. These were obtained together with the independent variables on the basis of 6-step scales by way of a validated, multidimensional questionnaire and were evaluated in bivariate and multivariate manner together with the routine data of the hospitals. The hospital data were retrieved from the structured quality reports of the hospitals. The analysis included 856 questionnaires of total knee endoprosthesis patients and 810 questionnaires of total hip endoprosthesis patients, which corresponded to a return rate of 12.04% and 11.89%, respectively. In the result of the multivariate analysis, the subjective outcomes of the treatment for both treatment groups were associated with overall satisfaction as well as with the readiness to return. Postoperative complications were in each case only associated with the willingness to return. In the case of total knee endoprosthesis patients, the friendliness of the nurses, the organization, and the course of examinations as well as the room equipment had an influence on the willingness to return. The latter, together with the quality of the food, was related to the overall satisfaction in this patient group. In the total hip endoprosthesis patients, the readiness to return was also associated with assessing the duration of stay, the clarity of the doctors’ answers to patients, the cleanliness, and clear information provided of the operation as well as the maintenance of privacy during examinations. A further link to the overall satisfaction of total hip endoprosthesis patients was found, however, in the assessment of medical care and the assessment of the duration of stay. The hospital parameters of the number of patients treated, postoperative mobility, and reoperation were not related to the dependent variables. Respondents of both treatment groups also stated in equal measure that the quality of treatment is most important in their future choice of a hospital. On the other hand, the distance from the hospital to the place of residence, as well as the size of the hospital, was located in the lower segment of the evaluation. Various interventions could be identified, which could be categorized on the macro, meso, and micro level and of which their impacts are addressed to the individual patient as well as the decision makers in the healthcare system. The relevant influencing factors from the patient's view showed that satisfaction and the willingness to return are assessed differently and also vary between the knee and the hip endoprosthesis patients. The results provide valuable comprehensive information for hospitals and help medical professionals meet the expectations of knee and hip endoprosthesis patients, including personnel development, patient education, and catering. Patient satisfaction can affect compliance, resulting in an improved treatment outcome. As a result of a targeted increase in patient satisfaction, savings are possible due to a shorter hospital stay or more infrequent complications. Thus, the presence of patient satisfaction could be demonstrated within current DRG billing procedures and, in the future, taking into account the P4P approach, which in addition to an increase in revenue for the individual hospital at the same time can bring about savings on the health care system level. Considering the ongoing P4P approach, the results can serve as a basis to statistically assess the efficacy of patient satisfaction as one of four possible performance targets. The assessment of various parameters in the future choice of a hospital suggests that further access routes will not be disadvantageous from the patient's perspective due to the changing care structure.