title: The Net Promoter Score--an asset to patient experience surveys?
abstract: BACKGROUND
  In the search for more straightforward ways of summarizing patient experiences and satisfaction, there is growing interest in the Net Promoter Score (NPS): How likely is it that you would recommend our company to a friend or colleague?
  
  
  OBJECTIVE
  To assess what the NPS adds to patient experience surveys. The NPS was tested against three other constructs already used in current surveys to summarize patient experiences and satisfaction: global ratings, recommendation questions and overall scores calculated from patient experiences. To establish whether the NPS is a valid measure for summarizing patient experiences, its association with these experiences should be assessed.
  
  
  METHODS
  Associations between the NPS and the three other constructs were assessed and their distributions were compared. Also, the association between the NPS and patient experiences was assessed. Data were used from patient surveys of inpatient hospital care (N = 6018) and outpatient hospital care (N = 10 902) in six Dutch hospitals.
  
  
  RESULTS
  Analyses showed that the NPS was moderately to strongly correlated with the other three constructs. However, their distributions proved distinctly different. Furthermore, the patient experiences from the surveys showed weaker associations with the NPS than with the global rating and the overall score.
  
  
  CONCLUSIONS
  Because of the limited extent to which the NPS reflects the survey results, it seems less valid as a summary of patient experiences than a global rating, the existing recommendation question or an overall score calculated from patient experiences. In short, it is still unclear what the NPS specifically adds to patient experience surveys.
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
authors.forename: Maarten W
authors.initials: MW
authors.lastname: Krol
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
authors.forename: Dolf
authors.initials: D
authors.lastname: de Boer
authors.affiliation: TRANZO, Tilburg University, Tilburg, The Netherlands.|Institute for Quality in Health Care, Diemen, The Netherlands.
authors.forename: Diana M
authors.initials: DM
authors.lastname: Delnoij
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
authors.forename: Jany J D J M
authors.initials: JJ
authors.lastname: Rademakers
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D019538:Health Care Surveys; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011787:Quality of Health Care
keywords: patient satisfaction; patient surveys; quality of care; survey research