title: Inpatient psychiatric care experience and its relationship to posthospitalization treatment participation.
abstract: OBJECTIVE
  This study used factor analysis of a Veterans Health Administration (VHA) survey to identify factors that measure satisfaction with inpatient treatment and to examine the factors' utility in evaluating treatment participation following discharge.
  
  
  METHODS
  The Survey of Healthcare Experiences of Patients (inpatient version) (I-SHEP) was mailed to 34,237 veterans who were discharged from inpatient to outpatient care in the VHA during fiscal year 2009 and was completed by 7,408 patients. A factor analysis of survey responses identified underlying I-SHEP factors and evaluated relationships between the factors, patient characteristics, and attendance at VHA mental health appointments within seven and 30 days of discharge.
  
  
  RESULTS
  The factor analysis identified three domains of satisfaction: respect and caring by nurses-overall hospital impression; involvement and information about care; and respect and caring by doctors. These factors demonstrated good internal consistency (Cronbach's α=.93, .90, and .94, respectively) and accounted for a moderate amount of variance in patient responses (r2=.167). Only the care involvement and information factor was associated with participation in follow-up care: increased satisfaction (one standard deviation change in scale score) was associated with improved odds of a mental health visit within seven and 30 days of discharge (odds ratio=1.14 and 1.17, respectively, p<.01).
  
  
  CONCLUSIONS
  After discharge, persons may not generalize satisfaction about the respect and caring shown by inpatient treatment teams toward their decision to attend outpatient care. Providing patients with information about treatment and involving them in care decisions during inpatient care may help facilitate the transition to outpatient settings.
authors.affiliation: Serious Mental Illness Treatment Resource and Evaluation Center, Health Services Research and Development Service, Department of Veterans Affairs Ann Arbor Healthcare System, North Campus Research Complex, Ann Arbor, MI 48109, USA. nickbowe@med.umich.edu
authors.forename: Nicholas W
authors.initials: NW
authors.lastname: Bowersox
authors.forename: Amy S B
authors.initials: AS
authors.lastname: Bohnert
authors.forename: Dara
authors.initials: D
authors.lastname: Ganoczy
authors.forename: Paul N
authors.initials: PN
authors.lastname: Pfeiffer
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000592:standards*; D005260:Female; D006306:Health Surveys; D006778:Hospitals, Psychiatric / Q000592:standards; D006787:Hospitals, Veterans / Q000592:standards; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000592:standards*; D010351:Patient Discharge / Q000592:standards; D010358:Patient Participation / Q000523:psychology*; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D014481:United States