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Do Hospitals With Lower Mortality Have Higher Patient Satisfaction? A Regional Analysis of Patients With Medical Diagnoses

Division of General Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA

Gary E. Rosenthal, MD

Iowa City VA Medical Center, Departments of Internal Medicine and Health Management and Policy, University of Iowa College of Medicine, and Division of General Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, gary-rosenthal{at}uiowa.edu

Although patient satisfaction is a widely used indicator of quality, relationships between satisfaction and other indicators are poorly studied. The current study examined hospital-level correlations between patient satisfaction and severity-adjusted mortality for 29 hospitals in northeastern Ohio during 1993-1997. Satisfaction with 6 dimensions of care was measured using a validated survey of 42,255 randomly selected patients with medical diagnoses. Severity-adjusted mortality rates were determined for 200,562 consecutive patients with 6 high-volume medical diagnoses. Analyses found that satisfaction scores were inversely correlated with mortality rates. For the cumulative 5-year period, correlations were significant or of borderline significance for 5 of the 6 dimensions (coordination [R = -0.40; P = .03], discharge instructions [R = -0.39; P = .04], overall quality [R = -0.38; P = .04], information provided [R = -0.37; P = .05], and nursing [R = -0.35; P = .06]). The correlation was weakest for physician care (R = -0.07; P = .72). These findings indicate that hospitals with higher patient satisfaction also tended to have lower severity-adjusted mortality. Associations were strongest for dimensions of satisfaction measuring patient communication, coordination of care, and nursing care and weakest for physician care.

Key Words: Mortality (hospital) • outcomes • patient satisfaction • quality of healthcare • severity of illness

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