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.
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. 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. Another critical factor influencing patient satisfaction is the job satisfaction experienced by the care-provider.
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.
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.
By 1998 the process of measuring and reporting of patient satisfaction had become an established industry.
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. 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. 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. 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.
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- Simple Tips to Improve Patient Satisfaction By Michael Pulia. American Academy of Emergency Medicine. 2011;18(1):18–19.
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- 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