Patient satisfaction

Patient satisfaction is a measure of the extent to which a patient is content with the health care which they received from their health care provider.

In evaluations of health care quality, patient satisfaction is a performance indicator measured in a self-report study and a specific type of customer satisfaction metric.

## Contents

* 1 Validity as a metric for evaluating health care quality
* 2 Factors influencing patient satisfaction
* 3 By region
* 4 Research
* 5 References

## Validity as a metric for evaluating health care quality

Because patients may be dissatisfied with health care which improves their health or satisfied with health care which does not, there are circumstances in which patient satisfaction is not a valid indicator of health care quality even though it is often used as such.

Many studies in acute medicine have failed to identify a relationship between patient satisfaction and health care quality.[1][2] However, in long-term conditions such as rheumatoid arthritis and other chronic inflammatory arthritides patient satisfaction with care has been measured reliably[3][4][5] and shown to be an outcome of care.[6][7][8][9][10][11][12][13]

## Factors influencing patient satisfaction

Patients' satisfaction with an encounter with health care service is mainly dependent on the duration and efficiency of care, and how empathetic and communicative the health care providers are.[14] It is favored by a good doctor-patient relationship. Also, patients who are well-informed of the necessary procedures in a clinical encounter, and the time it is expected to take, are generally more satisfied even if there is a longer waiting time.[14] Another critical factor influencing patient satisfaction is the job satisfaction experienced by the care-provider.

Another factor influencing patient satisfaction is the dynamic of power between the patient and practitioner. Perceived power imbalances—often stemming from differences in medical knowledge or communication styles—may lead some patients to feel intimidated, patronized, or disempowered during healthcare interactions, potentially decreasing their overall satisfaction.

One proposed method for addressing this issue is collaborative communication, a model in which the patient and healthcare provider engage as partners in the care process. This approach emphasizes shared decision-making, mutual respect, and open dialogue. By fostering a more equitable relationship, collaborative communication has been associated with increased patient trust, transparency, and satisfaction with care.[15]

## By region

In the United States, hospitals whose surgery patients reported being highly satisfied also performed higher quality surgical procedures. The implication of this is that there does not need to be trade-off between high patient satisfaction and quality patient care.[16]

The Consumer Assessment of Healthcare Providers and Systems or CAHPS survey is an ongoing research project to guide the development of consumer surveys being used assess the quality of care provided by health plans, physician groups, and clinicians. It is an example of a major research effort which studies the significance of consumer responses to surveys.

## Research

By 1998 the process of measuring and reporting of patient satisfaction had become an established industry.[17]

A concern about asking patients about the quality of their care is that patients tend to be more satisfied by attractive healthcare than by effective healthcare, and satisfaction reports may not give good information about the ability of a hospital, doctor, or treatment to improve their health.[18][19] Higher patient satisfaction have been associated with less emergency department use but with greater inpatient use, higher overall health care and prescription drug expenditures, and increased mortality.[20] Despite these concerns, more and more research has established customer satisfaction as a valid and reliable measure of customer behaviors and organizational performance. reduced complaint behavior about their primary care physician, and lower likelihood of terminating a relationship Among healthcare consumers—i.e., patients—satisfaction is best understood as a multi-attribute model with different aspects of care determining overall satisfaction. Importantly, lower performance on an attribute creates much more dissatisfaction than the satisfaction generated by higher performance on an attribute; in other words, negative performance is more consequential than positive performance.[21] Thus, ensuring overall patient satisfaction, it is more important to reduce negative performance on the patient-care dimension with the worst perceived performance than to maximize positive performance on another dimension. A fruitful solution can be measuring patient dissatisfaction instead of satisfaction.[22]

## References

1. ↑ Farley, Heather; Enguidanos, Enrique R.; Coletti, Christian M.; Honigman, Leah; Mazzeo, Anthony; Pinson, Thomas B.; Reed, Kevin; Wiler, Jennifer L. (2014). "Patient Satisfaction Surveys and Quality of Care: An Information Paper". Annals of Emergency Medicine 64 (4): 351–357. doi:10.1016/j.annemergmed.2014.02.021. ISSN 0196-0644. PMID 24656761.
2. ↑ The Farley paper cites these and others:
* Rao, M; Clarke, A; Sanderson, C; Hammersley, R (1 July 2006). "Patients' own assessments of quality of primary care compared with objective records based measures of technical quality of care: cross sectional study.". BMJ (Clinical Research Ed.) 333 (7557): 19. doi:10.1136/bmj.38874.499167.7c. PMID 16793783.
* Chang, JT; Hays, RD; Shekelle, PG; MacLean, CH; Solomon, DH; Reuben, DB; Roth, CP; Kamberg, CJ et al. (2 May 2006). "Patients' global ratings of their health care are not associated with the technical quality of their care.". Annals of Internal Medicine 144 (9): 665–72. doi:10.7326/0003-4819-144-9-200605020-00010. PMID 16670136.
* Schneider, EC; Zaslavsky, AM; Landon, BE; Lied, TR; Sheingold, S; Cleary, PD (December 2001). "National quality monitoring of Medicare health plans: the relationship between enrollees' reports and the quality of clinical care.". Medical Care 39 (12): 1313–25. doi:10.1097/00005650-200112000-00007. PMID 11717573.
* Sack, C; Scherag, A; Lütkes, P; Günther, W; Jöckel, KH; Holtmann, G (June 2011). "Is there an association between hospital accreditation and patient satisfaction with hospital care? A survey of 37,000 patients treated by 73 hospitals.". International Journal for Quality in Health Care 23 (3): 278–83. doi:10.1093/intqhc/mzr011. PMID 21515636.
* Solberg, LI; Asche, SE; Fontaine, P; Flottemesch, TJ; Pawlson, LG; Scholle, SH (January 2011). "Relationship of clinic medical home scores to quality and patient experience.". The Journal of Ambulatory Care Management 34 (1): 57–66. doi:10.1097/jac.0b013e3181ff6faf. PMID 21160353.
* Avery, KN; Metcalfe, C; Nicklin, J; Barham, CP; Alderson, D; Donovan, JL; Blazeby, JM (June 2006). "Satisfaction with care: an independent outcome measure in surgical oncology.". Annals of Surgical Oncology 13 (6): 817–22. doi:10.1245/aso.2006.08.019. PMID 16614882.
3. ↑ Hill, J. (February 1997). "Patient satisfaction in a nurse-led rheumatology clinic". Journal of Advanced Nursing 25 (2): 347–354. doi:10.1046/j.1365-2648.1997.1997025347.x. ISSN 0309-2402. PMID 9044010.
4. ↑ Hill, Jackie (February 1997). "Patient satisfaction in a nurse-led rheumatology clinic" (in en). Journal of Advanced Nursing 25 (2): 347–354. doi:10.1046/j.1365-2648.1997.1997025347.x. ISSN 0309-2402. PMID 9044010. https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-2648.1997.1997025347.x.
5. ↑ Cho, Soo-Kyung; Kim, Hyoungyoung; Song, Yeo-Jin; Nam, Eunwoo; Jones, Bethan; Ndosi, Mwidimi; Sung, Yoon-Kyoung (2022-08-09). "Validation of the Korean Leeds satisfaction questionnaire in rheumatoid arthritis with Rasch models". International Journal of Rheumatic Diseases 25 (11): 1270–1278. doi:10.1111/1756-185X.14419. ISSN 1756-185X. PMID 35945672.
6. ↑ Ndosi, Mwidimi; Lewis, Martyn; Hale, Claire; Quinn, Helen; Ryan, Sarah; Emery, Paul; Bird, Howard; Hill, Jackie (August 2011). "A randomised, controlled study of outcome and cost effectiveness for RA patients attending nurse-led rheumatology clinics: study protocol of an ongoing nationwide multi-centre study". International Journal of Nursing Studies 48 (8): 995–1001. doi:10.1016/j.ijnurstu.2011.01.010. ISSN 1873-491X. PMID 21334623.
7. ↑ Connolly, Carmel; Cotter, Patrick (2021-12-30). "Effectiveness of nurse-led clinics on healthcare delivery: An umbrella review". Journal of Clinical Nursing 32 (9–10): 1760–1767. doi:10.1111/jocn.16186. ISSN 1365-2702. PMID 34970816.
8. ↑ Thurah, Annette de; Esbensen, Bente Appel; Roelsgaard, Ida Kristiane; Frandsen, Tove Faber; Primdahl, Jette (2017-08-01). "Efficacy of embedded nurse-led versus conventional physician-led follow-up in rheumatoid arthritis: a systematic review and meta-analysis" (in en). RMD Open 3 (2). doi:10.1136/rmdopen-2017-000481. ISSN 2056-5933. PMID 28879053. PMC 5574437. https://rmdopen.bmj.com/content/3/2/e000481.
9. ↑ Primdahl, Jette; Wagner, Lis; Holst, René; Hørslev-Petersen, Kim (July 2012). "The impact on self-efficacy of different types of follow-up care and disease status in patients with rheumatoid arthritis—A randomized trial" (in en). Patient Education and Counseling 88 (1): 121–128. doi:10.1016/j.pec.2012.01.012. PMID 22386009. https://linkinghub.elsevier.com/retrieve/pii/S0738399112000456.
10. ↑ Sørensen, J; Primdahl, J; Horn, Hc; Hørslev-Petersen, K (2015-01-02). "Shared care or nurse consultations as an alternative to rheumatologist follow-up for rheumatoid arthritis (RA) outpatients with stable low disease-activity RA: cost-effectiveness based on a 2-year randomized trial" (in en). Scandinavian Journal of Rheumatology 44 (1): 13–21. doi:10.3109/03009742.2014.928945. ISSN 0300-9742. PMID 25380077. http://www.tandfonline.com/doi/full/10.3109/03009742.2014.928945.
11. ↑ Koksvik, Hege Svean; Hagen, Kåre Birger; Rødevand, Erik; Mowinckel, Petter; Kvien, Tore K; Zangi, Heidi A (June 2013). "Patient satisfaction with nursing consultations in a rheumatology outpatient clinic: a 21-month randomised controlled trial in patients with inflammatory arthritides" (in en). Annals of the Rheumatic Diseases 72 (6): 836–843. doi:10.1136/annrheumdis-2012-202296. ISSN 0003-4967. PMID 23393144. https://ard.bmj.com/lookup/doi/10.1136/annrheumdis-2012-202296.
12. ↑ Larsson, Ingrid; Fridlund, Bengt; Arvidsson, Barbro; Teleman, Annika; Bergman, Stefan (January 2014). "Randomized controlled trial of a nurse-led rheumatology clinic for monitoring biological therapy" (in en). Journal of Advanced Nursing 70 (1): 164–175. doi:10.1111/jan.12183. ISSN 0309-2402. PMID 23772698.
13. ↑ van Eijk-Hustings, Yvonne; van Tubergen, Astrid; Boström, Carina; Braychenko, Elena; Buss, Beate; Felix, José; Firth, Jill; Hammond, Alison et al. (January 2012). "EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis" (in en). Annals of the Rheumatic Diseases 71 (1): 13–19. doi:10.1136/annrheumdis-2011-200185. ISSN 0003-4967. PMID 22039168.
14. ↑ 14.0 14.1 Simple Tips to Improve Patient Satisfaction By Michael Pulia. American Academy of Emergency Medicine. 2011;18(1):18–19.
15. ↑ Communicating About Health. ISBN 978-0-19-766433-9.
16. ↑ Tsai, Thomas C.; Orav, E. John; Jha, Ashish K. (January 2015). "Patient satisfaction and quality of surgical care in US hospitals". Annals of Surgery 261 (1): 2–8. doi:10.1097/SLA.0000000000000765. ISSN 1528-1140. PMID 24887985.
17. ↑ Kravitz, Richard (1998). "Patient satisfaction with health care". Journal of General Internal Medicine 13 (4): 280–282. doi:10.1046/j.1525-1497.1998.00084.x. ISSN 0884-8734. PMID 9565395.
18. ↑ Falkenberg, Kai (21 January 2013). "Why Rating Your Doctor Is Bad For Your Health". forbes.com. https://www.forbes.com/sites/kaifalkenberg/2013/01/02/why-rating-your-doctor-is-bad-for-your-health/.
19. ↑ Rosenbaum, Lisa (23 July 2013). "When Doctors Tell Patients What They Don't Want to Hear". newyorker.com. https://www.newyorker.com/tech/elements/when-doctors-tell-patients-what-they-dont-want-to-hear.
20. ↑ Fenton JJ, Jerant AF, Bertakis KD, Franks P (2012). "The Cost of SatisfactionA National Study of Patient Satisfaction, Health Care Utilization, Expenditures, and Mortality". Arch Intern Med 172 (5): 405–411. doi:10.1001/archinternmed.2011.1662. PMID 22331982.
21. ↑ Otani K, Harris L, Tierney W. A paradigm shift in patient satisfaction assessment. Medical Care Research And Review [serial online]. September 2003;60(3):347-365.
22. ↑ Omid Rasouli and Mohammad Hossein Zarei, "Monitoring and Reducing Patient Dissatisfaction: A Case Study of an Iranian Public Hospital", Total Quality Management & Business Excellence, vol. 27 no. 5-6, pp. 531-559, 2016. https://dx.doi.org/10.1080/14783363.2015.1016869

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