title: Does the patient's inherent rating tendency influence reported satisfaction scores and affect division ranking?
abstract: OBJECTIVE
  To determine the impact of adjusting for rating tendency (RT) on patient satisfaction scores in a large teaching hospital and to assess the impact of adjustment on the ranking of divisions.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Large 2200-bed university teaching hospital.
  
  
  METHODS
  All adult patients hospitalized during a 1-month period in one of 20 medical divisions.
  
  
  METHODS
  None.
  
  
  METHODS
  Patient experience of care measured by the Picker Patient Experience questionnaire and RT scores.
  
  
  RESULTS
  Problem scores were weakly but significantly associated with RT. Division ranking was slightly modified in RT adjusted models. Division ranking changed substantially in case-mix adjusted models.
  
  
  CONCLUSIONS
  Adjusting patient self-reported problem scores for RT did impact ranking of divisions, although marginally. Further studies are needed to determine the impact of RT when comparing different institutions, particularly across inter-cultural settings, where the difference in RT may be more substantial.
authors.affiliation: Division of Quality of Care, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Patricia
authors.initials: P
authors.lastname: Francis
authors.affiliation: Division of Clinical Epidemiology, University Hospitals of Geneva, Geneva, Switzerland Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Thomas
authors.initials: T
authors.lastname: Agoritsas
authors.affiliation: Division of Quality of Care, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Pierre
authors.initials: P
authors.lastname: Chopard
authors.affiliation: Division of Clinical Epidemiology, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Perneger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003953:Diagnosis-Related Groups; D005260:Female; D006748:Hospital Departments / Q000592:standards / Q000706:statistics & numerical data; D006784:Hospitals, Teaching / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000592:standards / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: case-mix adjustment; patient satisfaction; rating tendency; survey