Patient satisfaction explained

Patient satisfaction is a measure of the extent to which a patient is content with the health care which they received from their health care provider.

In evaluations of health care quality, patient satisfaction is a performance indicator measured in a self-report study and a specific type of customer satisfaction metric.

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

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]

Notes and References

  1. Farley. Heather. Enguidanos. Enrique R.. Coletti. Christian M.. Honigman. Leah. Mazzeo. Anthony. Pinson. Thomas B.. Reed. Kevin. Wiler. Jennifer L.. Patient Satisfaction Surveys and Quality of Care: An Information Paper. Annals of Emergency Medicine. 2014. 0196-0644. 10.1016/j.annemergmed.2014.02.021. 24656761. 64. 4. 351–357.
  2. The Farley paper cites these and others:
    • Rao. M. Clarke. A. Sanderson. C. Hammersley. R. Patients' own assessments of quality of primary care compared with objective records based measures of technical quality of care: cross sectional study.. BMJ (Clinical Research Ed.). 1 July 2006. 333. 7557. 19. 16793783. 10.1136/bmj.38874.499167.7c. 1488754.
    • Chang. JT. Hays. RD. Shekelle. PG. MacLean. CH. Solomon. DH. Reuben. DB. Roth. CP. Kamberg. CJ. Adams. J. Young. RT. Wenger. NS. Patients' global ratings of their health care are not associated with the technical quality of their care.. Annals of Internal Medicine. 2 May 2006. 144. 9. 665–72. 16670136. 10.7326/0003-4819-144-9-200605020-00010. 10.1.1.460.3525. 53091172.
    • Schneider. EC. Zaslavsky. AM. Landon. BE. Lied. TR. Sheingold. S. Cleary. PD. National quality monitoring of Medicare health plans: the relationship between enrollees' reports and the quality of clinical care.. Medical Care. December 2001. 39. 12. 1313–25. 11717573. 10.1097/00005650-200112000-00007. 35720105.
    • Sack. C. Scherag. A. Lütkes. P. Günther. W. Jöckel. KH. Holtmann. G. Is there an association between hospital accreditation and patient satisfaction with hospital care? A survey of 37,000 patients treated by 73 hospitals.. International Journal for Quality in Health Care . June 2011. 23. 3. 278–83. 21515636. 10.1093/intqhc/mzr011. free.
    • Solberg. LI. Asche. SE. Fontaine. P. Flottemesch. TJ. Pawlson. LG. Scholle. SH. Relationship of clinic medical home scores to quality and patient experience.. The Journal of Ambulatory Care Management. January 2011. 34. 1. 57–66. 21160353. 10.1097/jac.0b013e3181ff6faf. 24132999.
    • Avery. KN. Metcalfe. C. Nicklin. J. Barham. CP. Alderson. D. Donovan. JL. Blazeby. JM. Jane Blazeby. Satisfaction with care: an independent outcome measure in surgical oncology.. Annals of Surgical Oncology. June 2006. 13. 6. 817–22. 16614882. 10.1245/aso.2006.08.019. 25373230.
  3. Hill . J. . February 1997 . Patient satisfaction in a nurse-led rheumatology clinic . Journal of Advanced Nursing . 25 . 2 . 347–354 . 10.1046/j.1365-2648.1997.1997025347.x . 0309-2402 . 9044010.
  4. Hill . Jackie . February 1997 . Patient satisfaction in a nurse‐led rheumatology clinic . Journal of Advanced Nursing . en . 25 . 2 . 347–354 . 10.1046/j.1365-2648.1997.1997025347.x . 9044010 . 0309-2402.
  5. Cho . Soo-Kyung . Kim . Hyoungyoung . Song . Yeo-Jin . Nam . Eunwoo . Jones . Bethan . Ndosi . Mwidimi . Sung . Yoon-Kyoung . 2022-08-09 . Validation of the Korean Leeds satisfaction questionnaire in rheumatoid arthritis with Rasch models . International Journal of Rheumatic Diseases . 25 . 11 . 1270–1278 . 10.1111/1756-185X.14419 . 1756-185X . 35945672. 251469263 .
  6. Ndosi . Mwidimi . Lewis . Martyn . Hale . Claire . Quinn . Helen . Ryan . Sarah . Emery . Paul . Bird . Howard . Hill . Jackie . August 2011 . A randomised, controlled study of outcome and cost effectiveness for RA patients attending nurse-led rheumatology clinics: study protocol of an ongoing nationwide multi-centre study . International Journal of Nursing Studies . 48 . 8 . 995–1001 . 10.1016/j.ijnurstu.2011.01.010 . 1873-491X . 3629570 . 21334623.
  7. Connolly . Carmel . Cotter . Patrick . 2021-12-30 . Effectiveness of nurse-led clinics on healthcare delivery: An umbrella review . Journal of Clinical Nursing . 32 . 9–10 . 1760–1767 . 10.1111/jocn.16186 . 1365-2702 . 34970816. 245593232 .
  8. Thurah . Annette de . Esbensen . Bente Appel . Roelsgaard . Ida Kristiane . Frandsen . Tove Faber . Primdahl . Jette . 2017-08-01 . Efficacy of embedded nurse-led versus conventional physician-led follow-up in rheumatoid arthritis: a systematic review and meta-analysis . RMD Open . en . 3 . 2 . e000481 . 10.1136/rmdopen-2017-000481 . 2056-5933 . 5574437 . 28879053.
  9. Primdahl . Jette . Wagner . Lis . Holst . René . Hørslev-Petersen . Kim . July 2012 . The impact on self-efficacy of different types of follow-up care and disease status in patients with rheumatoid arthritis—A randomized trial . Patient Education and Counseling . en . 88 . 1 . 121–128 . 10.1016/j.pec.2012.01.012. 22386009 .
  10. Sørensen . J . Primdahl . J . Horn . Hc . Hørslev-Petersen . K . 2015-01-02 . Shared care or nurse consultations as an alternative to rheumatologist follow-up for rheumatoid arthritis (RA) outpatients with stable low disease-activity RA: cost-effectiveness based on a 2-year randomized trial . Scandinavian Journal of Rheumatology . en . 44 . 1 . 13–21 . 10.3109/03009742.2014.928945 . 25380077 . 207460036 . 0300-9742.
  11. Koksvik . Hege Svean . Hagen . Kåre Birger . Rødevand . Erik . Mowinckel . Petter . Kvien . Tore K . Zangi . Heidi A . June 2013 . Patient satisfaction with nursing consultations in a rheumatology outpatient clinic: a 21-month randomised controlled trial in patients with inflammatory arthritides . Annals of the Rheumatic Diseases . en . 72 . 6 . 836–843 . 10.1136/annrheumdis-2012-202296 . 23393144 . 24873268 . 0003-4967.
  12. Larsson . Ingrid . Fridlund . Bengt . Arvidsson . Barbro . Teleman . Annika . Bergman . Stefan . January 2014 . Randomized controlled trial of a nurse‐led rheumatology clinic for monitoring biological therapy . Journal of Advanced Nursing . en . 70 . 1 . 164–175 . 10.1111/jan.12183 . 0309-2402 . 4285750 . 23772698.
  13. van Eijk-Hustings . Yvonne . van Tubergen . Astrid . Boström . Carina . Braychenko . Elena . Buss . Beate . Felix . José . Firth . Jill . Hammond . Alison . Harston . Benny . Hernandez . Cristina . Huzjak . Masa . Korandová . Jana . Kukkurainen . Marja Leena . Landewé . Robert . Mezieres . Maryse . January 2012 . EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis . Annals of the Rheumatic Diseases . en . 71 . 1 . 13–19 . 10.1136/annrheumdis-2011-200185 . 22039168 . 8451578 . 0003-4967. free .
  14. http://www.medscape.com/viewarticle/743875?src=mp&spon=25 Simple Tips to Improve Patient Satisfaction
  15. Tsai. Thomas C.. Orav. E. John. Jha. Ashish K.. January 2015. Patient satisfaction and quality of surgical care in US hospitals. Annals of Surgery. 261. 1. 2–8. 10.1097/SLA.0000000000000765. 1528-1140. 4248016. 24887985.
  16. Kravitz. Richard. Patient satisfaction with health care. Journal of General Internal Medicine. 13. 4. 1998. 280–282. 0884-8734. 10.1046/j.1525-1497.1998.00084.x. 9565395. 1496942.
  17. Web site: Why Rating Your Doctor Is Bad For Your Health . Kai . Falkenberg . forbes.com . 21 January 2013 . 3 April 2015.
  18. Web site: When Doctors Tell Patients What They Don't Want to Hear . Lisa . Rosenbaum . newyorker.com . 23 July 2013 . 3 April 2015.
  19. Fenton JJ, Jerant AF, Bertakis KD, Franks P . 2012 . The Cost of SatisfactionA National Study of Patient Satisfaction, Health Care Utilization, Expenditures, and Mortality . Arch Intern Med . 172 . 5. 405–411 . 10.1001/archinternmed.2011.1662 . 22331982 . free .
  20. 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.
  21. 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

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