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An “inverse satisfaction law”? Why don't older patients criticise health services?
  1. A Bowling
  1. Department of Primary Care and Population Sciences, University College London, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK

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    Health services across the developed world attract high satisfaction ratings from patients, regardless of levels of service effectiveness and equity of access. People aged 65 and over express higher levels of satisfaction with health services than younger adults, and they are much less likely than the latter to report difficulties in access to specialists. Such findings are consistent across different types of health systems, and regardless of whether surveys are sponsored by individual governments, private companies, independent research bodies, or collectively across countries by the Commonwealth Fund.

    The consistency with which high satisfaction ratings are obtained in patient satisfaction surveys explains why governments continue to sponsor them—using them to temper more uncomfortable, objective data (for example, on …

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