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The most recent models reflect the growing consumer orientation of health care, with patients being viewed as having rights to fair and considerate treatment, to information and to consideration of their needs. The principle motive for these models has come in the form of clinical audit and the use of patient satisfaction measures. To evaluate outcomes by looking beyond the limited endpoints of cure and morbidity rates has been the major shift in perspective of the last decade of the 20th Century.

Put simply, the quality of the DPR has a direct impact on the extent to which patients make decisions about service aspects, such as quality of care, and, while there is less evidence that satisfaction is linked to improved compliance with treatment, the likelihood of patients returning or of adverse reactions or problems is much higher.