title: Do hospitals with lower mortality have higher patient satisfaction? A regional analysis of patients with medical diagnoses.
abstract: Although patient satisfaction is a widely used indicator of quality, relationships between satisfaction and other indicators are poorly studied. The current study examined hospital-level correlations between patient satisfaction and severity-adjusted mortality for 29 hospitals in northeastern Ohio during 1993-1997. Satisfaction with 6 dimensions of care was measured using a validated survey of 42,255 randomly selected patients with medical diagnoses. Severity-adjusted mortality rates were determined for 200,562 consecutive patients with 6 high-volume medical diagnoses. Analyses found that satisfaction scores were inversely correlated with mortality rates. For the cumulative 5-year period, correlations were significant or of borderline significance for 5 of the 6 dimensions (coordination [R = -0.40; P = .03], discharge instructions [R = -0.39; P = .04], overall quality [R = -0.38; P = .04], information provided [R = -0.37; P = .05], and nursing [R = -0.35; P = .06]). The correlation was weakest for physician care (R = -0.07; P = .72). These findings indicate that hospitals with higher patient satisfaction also tended to have lower severity-adjusted mortality. Associations were strongest for dimensions of satisfaction measuring patient communication, coordination of care, and nursing care and weakest for physician care.
authors.affiliation: Division of General Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City 52242, USA.
authors.forename: C Komal
authors.initials: CK
authors.lastname: Jaipaul
authors.forename: Gary E
authors.initials: GE
authors.lastname: Rosenthal
mesh_terms: D006302:Health Services Research; D017052:Hospital Mortality / Q000639:trends; D006786:Hospitals, Urban / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D009820:Ohio / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D019984:Quality Indicators, Health Care; D020379:Risk Adjustment; D012720:Severity of Illness Index; D016896:Treatment Outcome