title: Patients' evaluation of hospital foodservice quality in Italy: what do patients really value?
abstract: OBJECTIVE
  Patients often do not eat/drink enough during hospitalization. To enable patients to meet their energy and nutritional requirements, food and catering service quality and staff support are therefore important. We assessed patients' satisfaction with hospital food and investigated aspects influencing it.
  
  
  METHODS
  We conducted a cross-sectional study collecting patients' preferences using a slightly modified version of the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire (ACHFPSQ). Factor analysis was carried out to reduce the number of food-quality and staff-issue variables. Univariate and multivariate ordinal categorical regression models were used to assess the association between food quality, staff issues, patients' characteristics, hospital recovery aspects and overall foodservice satisfaction (OS).
  
  
  METHODS
  A university hospital in Florence, Italy, in the period November-December 2009.
  
  
  METHODS
  Hospital patients aged 18+ years (n 927).
  
  
  RESULTS
  Of the 1288 questionnaires distributed, 927 were returned completely or partially filled in by patients and 603 were considered eligible for analysis. Four factors (explained variance 64·3 %, Cronbach's alpha α(C) = 0.856), i.e. food quality (FQ; α(C) = 0·74), meal service quality (MSQ; α(C) = 0·73), hunger and quantity (HQ; α(C) = 0·74) and staff/service issues (SI; α(C) = 0·65), were extracted from seventeen items. Items investigating staff/service issues were the most positively rated while certain items investigating food quality were the least positively rated. After ordinal multiple regression analysis, OS was only significantly associated with the four factors: FQ, MSQ, HQ and SI (OR = 17·2, 6·16, 3·09 and 1·75, respectively, P < 0·001), and gender (OR = 1·53, P = 0·024).
  
  
  CONCLUSIONS
  The most positively scored aspects of foodservice concerned staff/service, whereas food quality was considered less positive. The aspects that most influenced patients' satisfaction were those related to food quality.
authors.affiliation: Department of Public Health, Health Services Research Laboratory, University of Siena, Via Aldo Moro 2, 53100 Siena, Italy. gabriele.messina@unisi.it
authors.forename: Gabriele
authors.initials: G
authors.lastname: Messina
authors.forename: Roberto
authors.initials: R
authors.lastname: Fenucci
authors.forename: Francesco
authors.initials: F
authors.lastname: Vencia
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Niccolini
authors.forename: Cecilia
authors.initials: C
authors.lastname: Quercioli
authors.forename: Nicola
authors.initials: N
authors.lastname: Nante
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005260:Female; D063427:Food Quality; D005521:Food Service, Hospital; D006760:Hospitalization; D006801:Humans; D007297:Inpatients; D007558:Italy; D008297:Male; D062407:Meals; D008875:Middle Aged; D009753:Nutritive Value; D057240:Patient Preference; D011795:Surveys and Questionnaires