Challenging the holy grail of hospital accreditation: a cross sectional study of inpatient satisfaction in the field of cardiology.
BACKGROUND
Subjective parameters such as quality of life or patient satisfaction gain importance as outcome parameters and benchmarks in health care. In many countries hospitals are now undergoing accreditation as mandatory or voluntary measures. It is believed but unproven that accreditations positively influence quality of care and patient satisfaction. The present study aims to assess in a defined specialty (cardiology) the relationship between patient satisfaction (as measured by the recommendation rate) and accreditation status.


METHODS
Consecutive patients discharged from 25 cardiology units received a validated patient satisfaction questionnaire. Data from 3,037 patients (response rate > 55%) became available for analysis. Recommendation rate was used as primary endpoint. Different control variables such as staffing level were considered.


RESULTS
The 15 accredited units did not differ significantly from the 10 non-accredited units regarding main hospital (i.e. staffing levels, no. of beds) and patient (age, gender) characteristics. The primary endpoint "recommendation rate of a given hospital" for accredited hospitals (65.6%, 95% Confidence Interval (CI) 63.4 - 67.8%) and hospitals without accreditation (65.8%, 95% CI 63.1-68.5%) was not significantly different.


CONCLUSIONS
Our results support the notion that - at least in the field of cardiology - successful accreditation is not linked with measurable better quality of care as perceived by the patient and reflected by the recommendation rate of a given institution. Hospital accreditation may represent a step towards quality management, but does not seem to improve overall patient satisfaction.
Sack
Cornelia
C
Department of Strategy and Medical Planning, University Hospital Essen, Germany.
Lütkes
Peter
P
Günther
Wolfram
W
Erbel
Raimund
R
Jöckel
Karl-Heinz
KH
Holtmann
Gerald J
GJ
D000068:Accreditation / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D016507:Cardiology Service, Hospital / Q000592:standards / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany; D006742:Hospital Bed Capacity; D006761:Hospitals / Q000592:standards*; D006801:Humans; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D010351:Patient Discharge / Q000706:statistics & numerical data / Q000639:trends; D017060:Patient Satisfaction / Q000208:ethnology; D011787:Quality of Health Care; D012737:Sex Factors; D011795:Surveys and Questionnaires; D000078329:Workforce
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