title: Challenging the holy grail of hospital accreditation: a cross sectional study of inpatient satisfaction in the field of cardiology.
abstract: 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.
authors.affiliation: Department of Strategy and Medical Planning, University Hospital Essen, Germany.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Sack
authors.forename: Peter
authors.initials: P
authors.lastname: Lütkes
authors.forename: Wolfram
authors.initials: W
authors.lastname: Günther
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Jöckel
authors.forename: Gerald J
authors.initials: GJ
authors.lastname: Holtmann
mesh_terms: 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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