Patient satisfaction, quality not always aligned

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It's not exactly a shocker. A study published online last week in Circulation: Cardiovascular Quality and Outcomes found that patient satisfaction on average is low at America's lowest-performing hospitals. The surprising part of the study was that sometimes the two are disconnected. Study authors revealed that without a better understanding of what contributes to poor performance, pay-for-performance and value-based initiatives could backfire and could even adversely affect patient care, Health Imaging reported.

Researchers at University of Iowa Hospitals and Clinics and colleagues looked at Hospital Compare 2006 to 2008 data for acute myocardial infarction and heart failure process measures, as well as Hospital Consumer Assessment of Healthcare Providers and Systems 2008 data to compare hospitals. Low-performing hospitals tended to have fewer beds, fewer nurses per patient and were more likely rural, safety-net hospitals in the South, according to the study.

Not surprisingly, hospitals that consistently performed poorly in cardiac process measures also had lower patient satisfaction on average, indicating these hospitals have poor quality of care. However, the study authors also noted that "there is discordance between the 2 measures in profiling hospital quality."

For example, strangely enough, in heart failure hospitals, more than 61 percent of patients said they would recommend a low-performing hospital, according to Health Imaging. Nearly 40 percent of the low-performing heart failure hospitals were in the top half of patient satisfaction ratings, and 40 percent of the top-performing hospitals were in the bottom half.

"[T]hese findings illustrate that process measures and satisfaction ratings measure relatively distinct facets of hospital quality and support the notion that evaluation of hospital quality should be based on multiple measures," they wrote.

For more information:
- read the Health Imaging article
- here's the study abstract

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