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Perceptions of Care of Patients Undergoing Coronary Artery Bypass Surgery in Veterans Health Administration and Private Sector Hospitals

Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa

Mary Vaughan Sarrazin, PhD

Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa and Program for Interdisciplinary Research in Health Care Organization, Iowa City VA Medical Center, Iowa City, Iowa

Gary E. Rosenthal, MD

Program for Interdisciplinary Research in Health Care Organization, Iowa City VA Medical Center, Iowa City, Iowa, gary-rosenthal{at}uiowa.edu

Few studies have examined differences in patient perceptions of care between health care systems. This study compared the perceptions of male patients undergoing coronary artery bypass graft surgery in 43 Veterans Health Administration (VA) hospitals (N = 808) and 102 US private sector hospitals (N = 2271) from 1995 to 1998. Patient perceptions were measured by a validated survey that was mailed to patients after discharge. For 8 of the 9 dimensions assessed by the survey, VA patients were more likely (P < .001) than private sector patients to note a problem with care (eg, Coordination, 48% versus 40%; Patient Education and Communication, 50% versus 40%; Respect for Patient Preferences, 49% versus 41%). In comparisons limited to major teaching hospitals, VA patients were more likely to note a problem for 5 dimensions. The findings indicate that patient perceptions of care may be lower in VA than in private sector hospitals. Future studies should examine whether the VA's recent focus on improving patient satisfaction has narrowed these differences.

Key Words: Benchmarking • coronary artery bypass graft surgery • health care quality assurance • health care quality improve-ment • patient satisfaction • patient-centered care • Veterans hospitals

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