Validity as a metric for evaluating health care quality
Because patients may be dissatisfied with health care which improves their health or satisfied with health care which does not, there are circumstances in which patient satisfaction is not a valid indicator of health care quality even though it is often used as such.
Many studies in acute medicine have failed to identify a relationship between patient satisfaction and health care quality.[1][2] However, in long term conditions such as rheumatoid arthritis and other chronic inflammatory arthritides patient satisfaction with care has been measured reliably[3][4][5] and shown to be an outcome of care.[6][7][8][9][10][11][12][13]
Factors influencing patient satisfaction
Patients' satisfaction with an encounter with health care service is mainly dependent on the duration and efficiency of care, and how empathetic and communicative the health care providers are.[14] It is favored by a good doctor-patient relationship. Also, patients who are well-informed of the necessary procedures in a clinical encounter, and the time it is expected to take, are generally more satisfied even if there is a longer waiting time.[14] Another critical factor influencing patient satisfaction is the job satisfaction experienced by the care-provider.
By region
In the United States, hospitals whose surgery patients reported being highly satisfied also performed higher quality surgical procedures. The implication of this is that there does not need to be trade-off between high patient satisfaction and quality patient care.[15]
The Consumer Assessment of Healthcare Providers and Systems or CAHPS survey is an ongoing research project to guide the development of consumer surveys being used assess the quality of care provided by health plans, physician groups, and clinicians. It is an example of a major research effort which studies the significance of consumer responses to surveys.
Research
By 1998 the process of measuring and reporting of patient satisfaction had become an established industry.[16]
A concern about asking patients about the quality of their care is that patients tend to be more satisfied by attractive healthcare than by effective healthcare, and satisfaction reports may not give good information about the ability of a hospital, doctor, or treatment to improve their health.[17][18] Higher patient satisfaction have been associated with less emergency department use but with greater inpatient use, higher overall health care and prescription drug expenditures, and increased mortality.[19] Despite these concerns, more and more research has established customer satisfaction as a valid and reliable measure of customer behaviors and organizational performance. reduced complaint behavior about their primary care physician, and lower likelihood of terminating a relationship [citation needed]
Among healthcare consumers—i.e., patients—satisfaction is best understood as a multi-attribute model with different aspects of care determining overall satisfaction. Importantly, lower performance on an attribute creates much more dissatisfaction than the satisfaction generated by higher performance on an attribute; in other words, negative performance is more consequential than positive performance.[20] Thus, ensuring overall patient satisfaction, it is more important to reduce negative performance on the patient-care dimension with the worst perceived performance than to maximize positive performance on another dimension. A fruitful solution can be measuring patient dissatisfaction instead of satisfaction.[21]
References
^Farley, Heather; Enguidanos, Enrique R.; Coletti, Christian M.; Honigman, Leah; Mazzeo, Anthony; Pinson, Thomas B.; Reed, Kevin; Wiler, Jennifer L. (2014). "Patient Satisfaction Surveys and Quality of Care: An Information Paper". Annals of Emergency Medicine. 64 (4): 351–357. doi:10.1016/j.annemergmed.2014.02.021. ISSN0196-0644. PMID24656761.
Chang, JT; Hays, RD; Shekelle, PG; MacLean, CH; Solomon, DH; Reuben, DB; Roth, CP; Kamberg, CJ; Adams, J; Young, RT; Wenger, NS (2 May 2006). "Patients' global ratings of their health care are not associated with the technical quality of their care". Annals of Internal Medicine. 144 (9): 665–72. CiteSeerX10.1.1.460.3525. doi:10.7326/0003-4819-144-9-200605020-00010. PMID16670136. S2CID53091172.
Schneider, EC; Zaslavsky, AM; Landon, BE; Lied, TR; Sheingold, S; Cleary, PD (December 2001). "National quality monitoring of Medicare health plans: the relationship between enrollees' reports and the quality of clinical care". Medical Care. 39 (12): 1313–25. doi:10.1097/00005650-200112000-00007. PMID11717573. S2CID35720105.
Solberg, LI; Asche, SE; Fontaine, P; Flottemesch, TJ; Pawlson, LG; Scholle, SH (January 2011). "Relationship of clinic medical home scores to quality and patient experience". The Journal of Ambulatory Care Management. 34 (1): 57–66. doi:10.1097/jac.0b013e3181ff6faf. PMID21160353. S2CID24132999.
Avery, KN; Metcalfe, C; Nicklin, J; Barham, CP; Alderson, D; Donovan, JL; Blazeby, JM (June 2006). "Satisfaction with care: an independent outcome measure in surgical oncology". Annals of Surgical Oncology. 13 (6): 817–22. doi:10.1245/aso.2006.08.019. PMID16614882. S2CID25373230.
^Otani K, Harris L, Tierney W. A paradigm shift in patient satisfaction assessment. Medical Care Research And Review [serial online]. September 2003;60(3):347-365.
^Omid Rasouli and Mohammad Hossein Zarei, "Monitoring and Reducing Patient Dissatisfaction: A Case Study of an Iranian Public Hospital", Total Quality Management & Business Excellence, vol. 27 no. 5-6, pp. 531-559, 2016. https://dx.doi.org/10.1080/14783363.2015.1016869