Patient Experience and Satisfaction with Chiropractic Care: A National Survey
SOURCE: BMC Health Serv Res 2025 (Nov 26)
Line Lyskjær • Werner Vach • Casper Nim • Steen Harsted • Marlene Øllegaard Terkelsen • Rikke Krüger Jensen
Chiropractic Knowledge Hub,
Odense, Denmark
Background Patient experience and satisfaction are important to stakeholders in the healthcare system, including payers, providers and patients. This study explores the patient experience and satisfaction with chiropractic care in Denmark including how aspects of patient experience and patient characteristics influence overall satisfaction.
Methods A national survey was conducted over a two-week period in January 2023, targeting patients in all chiropractic clinics in Denmark. Clinics were asked to invite all patients to participate. Enrolled participants completed an electronic survey, containing 28 items on patient experience and satisfaction (5-point Likert scale). Associations of aspects of patient experience and patient characteristics with overall satisfaction were analysed with ordinal regression. Variation across clinics was analysed by forest plots and random effect models.
Results Of the 250 clinics invited, 228 clinics (91%) recruited 27,577 patients for the survey (invitation rate of 53%). Of these, 17,974 (65%) were included in the final analysis. Patients reported ‘very high’ or ‘high’ degree of overall satisfaction with care (97%). Overall satisfaction was associated with personal experiences involving the chiropractor, particularly in the areas of examination and communication, patient involvement and information, and perceived effectiveness and reassurance. Lower satisfaction was linked to experiences involving delays, unexpected adverse events, and the process of collaboration with other health care professionals. Higher satisfaction was reported among women, patients under 30?years, and those with prior chiropractic care. Variation in overall satisfaction and patient experiences could not be fully explained by differences in known patient characteristics.
Conclusion While patients generally reported very high satisfaction with chiropractic care in Denmark, certain experiences and patient characteristics influenced this perception. Chiropractors should continue to prioritise quality interactions, personalised care, clear communication about risks of adverse events, and effective collaboration with other health care professionals.
Keywords: Chiropractic care; Patient experiences; Patient interaction; Patient satisfaction; Personalised care; Provider variation.
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Background
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Patient experience, including patient satisfaction, has become an increasing focus in healthcare due to its potential impact on patient safety, treatment adherence, and outcomes. [1] As a result, collecting patient experience data has become a key component in assessing the quality of healthcare services. [2] Many countries have established routines for measuring and publishing patient experience data as a result of governmental or other regulatory requirements, although the implications of patient feedback for system improvement are often unclear. [3]
In Denmark, chiropractors work as independent contractors regulated by the Danish National Health Authorities. The terms of regulation include a collective agreement negotiated by the Danish Health Authorities and the Danish Chiropractic Association (DCA). The 2021 agreement led to the establishment of a Quality Unit, which was responsible for implementing a quality model in chiropractic practice, with patient satisfaction identified as one of the core quality indicators. [4] In alignment with this mandate, the Quality Unit planned and conducted a National Survey of Patient Experience and Satisfaction with Chiropractic Care.
In Denmark, systematic measurement of patient experience is well established in the public healthcare sector, where national surveys such as the “Nationwide survey of patient experiences” [5] are conducted every year to monitor and improve the quality of care.
High levels of patient satisfaction with chiropractic care have consistently been reported). [6-9] Satisfaction is influenced by factors such as perceived treatment effectiveness and pain improvement [10], 1thorough examinations, time spent during consultation, the chiropractor’s communication about diagnosis and prognosis, and coordination of care. [6]
Although patient experience and satisfaction with chiropractic care has been studied extensively, a recent systematic review highlights gaps in knowledge, particularly with regard to factors that are associated with patient satisfaction and how these factors can be used to improve the patient experience. [11] Furthermore, most of the studies identified in the review had sample sizes of less than 1000 patients or were based on selected samples. To date, no comprehensive national study of patient experience and satisfaction with chiropractic care has been conducted.
Therefore, this study addresses the gap by analysing data from the National Survey of Patient Experience and Satisfaction with Danish Chiropractic Care. The study aimed to
(ii) describe specific aspects of patient experience,
(iii) investigate how aspects of experiences and patient characteristics are associated with satisfaction, and
(iv) investigate variation in overall satisfaction and
specific domains of experience across chiropractic clinics.
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