title: Is there a relationship between patient satisfaction and favorable outcomes?
abstract: OBJECTIVE
  Patient satisfaction with the health care experience has become a top priority for Centers for Medicare and Medicaid Services. With resources and efforts directed at patient satisfaction, we evaluated whether high patient satisfaction measured by HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) surveys correlates with favorable outcomes.
  
  
  METHODS
  Medical centers were identified from the University HealthSystem Consortium database from 2011 to 2012. Variables included hospital characteristics, process measure compliance, and surgical outcomes. Chi-squared analysis was used to evaluate for variables associated with high patient satisfaction (defined as hospitals that scored above the 50th percentile of top box scores).
  
  
  RESULTS
  We identified 171 hospitals with complete data. The following variables were significantly associated with high overall patient satisfaction: large hospitals, high surgical volume, and low mortality (P < 0.001). Compliance with process measures and patient safety indicators, as well as length of stay, did not correlate with overall satisfaction. The presence of complications (P = 0.491) or increased rate of readmission (P = 0.056) were not found to affect patient satisfaction. Low mortality index was consistently found to be associated with high satisfaction across 9 of 10 HCAHPS domains.
  
  
  CONCLUSIONS
  We found that hospital size, surgical volume, and low mortality were associated with high overall patient satisfaction. However, with the exception of low mortality, favorable surgical outcomes were not consistently associated with high HCAHPS scores. With existing satisfaction surveys, we conclude that factors outside of surgical outcomes appear to influence patients' perceptions of their care.
authors.affiliation: From the University of Wisconsin Department of Surgery, Madison.
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Kennedy
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Tevis
authors.forename: K Craig
authors.initials: KC
authors.lastname: Kent
mesh_terms: D019538:Health Care Surveys; D006276:Health Facility Size; D017052:Hospital Mortality; D061847:Hospitals, High-Volume / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D010359:Patient Readmission / Q000706:statistics & numerical data; D061214:Patient Safety / Q000592:standards; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology