Mental illness as a predictor of satisfaction with inpatient care at Veterans Affairs hospitals.
OBJECTIVE
Patient satisfaction ratings are increasingly being used as an indicator of quality of care. However, satisfaction scores do not account for differences in satisfaction among patients that may be attributable to sociodemographic characteristics or type of illness rather than to the quality of service delivery. This study examines the role of psychiatric diagnosis in satisfaction with inpatient care delivered at Department of Veterans Affairs (VA) hospitals.


METHODS
Data were taken from a large national VA customer feedback survey of patients discharged from VA hospitals between June 1 and August 31, 1995 (N=38,789). Analyses examined whether patients discharged with a psychiatric diagnosis were less satisfied with care than those discharged with a nonpsychiatric diagnosis.


RESULTS
Patients with a psychiatric diagnosis were less satisfied with their care, regardless of whether they were treated in a psychiatric treatment program or a medical unit, and this relationship remained after the analysis adjusted for other determinants of satisfaction. The association between low satisfaction and psychiatric diagnosis was more pronounced among nonblack patients.


CONCLUSIONS
The results suggest the need for caution in using patient satisfaction measures to compare mental health programs and other health care programs.
Hoff
R A
RA
Practice Pattern Research Unit, Department of Veterans Affairs Northeast Program Evaluation Center, West Haven, CT 06516, USA. rani.hoff@yale.edu
Rosenheck
R A
RA
Meterko
M
M
Wilson
N J
NJ
D000328:Adult; D016009:Chi-Square Distribution; D003953:Diagnosis-Related Groups / Q000592:standards*; D005260:Female; D019538:Health Care Surveys; D006787:Hospitals, Veterans / Q000592:standards*; D006801:Humans; D016014:Linear Models; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000592:standards; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000592:standards; D015203:Reproducibility of Results; D012494:Sampling Studies; D014481:United States; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data