title: Is there an association between hospital accreditation and patient satisfaction with hospital care? A survey of 37,000 patients treated by 73 hospitals.
abstract: OBJECTIVE
  In many countries hospitals are undergoing accreditation as mandatory or voluntary measures. It is believed that accreditation positively influence quality of care and patient satisfaction. This survey aims at assessing the relationship between patient satisfaction and accreditation status.
  
  
  METHODS
  Between January and May 2007, 4 weeks after their discharge, 78 508 patients from 328 departments in 73 hospitals received a validated questionnaire. Data from 36 777 patients (response rate 55%) were available for analyses.
  
  
  METHODS
  Recommendation rate was used as primary endpoint, which was available from 35 945 patients. To address the clustering of patients within hospitals, we applied univariate and multivariable generalized estimating equations. As covariates we used 'gender' and 'age' at the patient level and the 'number of beds' and 'hospital teaching status' at the hospital level.
  
  
  RESULTS
  Overall and not addressing the clustering, 66.3% of all the patients recommend their hospital to others. This recommendation, however, was not related to the accreditation status in the univariate analyses (odds ratio (OR) for accreditation ('yes') and recommendation ('yes') 0.99, 95% confidence interval (CI) 0.85-1.16, P= 0.92). This result was similar in the multivariable regression model adjusted for clustering (OR = 0.98, 95% CI 0.84-1.13, P= 0.74).
  
  
  CONCLUSIONS
  Our results support the notion that accreditation is not linked to measurable better quality of care as perceived by the patient. Hospital accreditation may represent a step towards total quality management, but may not be a key factor to quality of care measured by the patient's willingness to recommend.
authors.affiliation: Department of Strategy and Medical Planning, University Hospital Essen, Essen, Germany. cornelia.sack@uk-essen.de
authors.forename: C
authors.initials: C
authors.lastname: Sack
authors.forename: A
authors.initials: A
authors.lastname: Scherag
authors.forename: P
authors.initials: P
authors.lastname: Lütkes
authors.forename: W
authors.initials: W
authors.lastname: Günther
authors.forename: K-H
authors.initials: KH
authors.lastname: Jöckel
authors.forename: G
authors.initials: G
authors.lastname: Holtmann
mesh_terms: D000068:Accreditation; D000368:Aged; D005260:Female; D005858:Germany; D006760:Hospitalization; D006761:Hospitals / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011787:Quality of Health Care / Q000592:standards*; D011795:Surveys and Questionnaires