title: The number of inpatient consultations is negatively correlated with patient satisfaction in patients with prolonged hospital stays.
abstract: BACKGROUND
  Patient satisfaction is often measured using the Hospital Consumer Assessment of Healthcare Providers and Systems survey. Our aim was to examine the structural and clinical determinants of satisfaction among inpatients with prolonged lengths of stays (LOS).
  
  
  METHODS
  Adult patients who were admitted between 2009 and 2012, had a LOS of 21 days or more, and completed the Hospital Consumer Assessment of Healthcare Providers and Systems survey, were included. Univariate analyses assessed the relationship between satisfaction and patient/system variables. Recursive partitioning was used to examine the relative importance of the identified variables.
  
  
  RESULTS
  One hundred one patients met inclusion criteria. The average LOS was 35 days and 58% were admitted to a surgical service. Satisfaction with physician communication was significantly associated with fewer consultations (P < .01), nonoperative admission (P < .001), no intensive care unit stay (P < .01), nonsurgical service (P < .01), and non-emergency room admissions (P = .03). Among these, having fewer consultations had the highest relative importance.
  
  
  CONCLUSIONS
  In long stay patients, having fewer inpatient consultations was the strongest predictor of patient satisfaction with physician communication. This suggests that examination of patient-level data in clinically relevant subgroups may be a useful way to identify targets for quality improvement.
authors.affiliation: Department of Surgery, University of Wisconsin Clinical Science Center, University of Wisconsin, 600 Highland Avenue, Madison, WI 53792, USA.
authors.forename: Ryan K
authors.initials: RK
authors.lastname: Schmocker
authors.affiliation: Department of Surgery, University of Wisconsin Clinical Science Center, University of Wisconsin, 600 Highland Avenue, Madison, WI 53792, USA.
authors.forename: Sara E
authors.initials: SE
authors.lastname: Holden
authors.affiliation: Department of Surgery, University of Wisconsin Clinical Science Center, University of Wisconsin, 600 Highland Avenue, Madison, WI 53792, USA.
authors.forename: Xia
authors.initials: X
authors.lastname: Vang
authors.affiliation: Department of General Surgery, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Stephanie T
authors.initials: ST
authors.lastname: Lumpkin
authors.affiliation: Department of Surgery, University of Wisconsin Clinical Science Center, University of Wisconsin, 600 Highland Avenue, Madison, WI 53792, USA.
authors.forename: Linda M
authors.initials: LM
authors.lastname: Cherney Stafford
authors.affiliation: Department of Surgery, University of Wisconsin Clinical Science Center, University of Wisconsin, 600 Highland Avenue, Madison, WI 53792, USA.
authors.forename: Glen E
authors.initials: GE
authors.lastname: Leverson
authors.affiliation: Department of Surgery, University of Wisconsin Clinical Science Center, University of Wisconsin, 600 Highland Avenue, Madison, WI 53792, USA. Electronic address: winslow@surgery.wisc.edu.
authors.forename: Emily R
authors.initials: ER
authors.lastname: Winslow
mesh_terms: D000328:Adult; D000368:Aged; D003142:Communication; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies
keywords: HCAHPS; Patient satisfaction; Physician communication; Surgery service