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Patient satisfaction best predictor of hospital care

When searching for high-quality hospital care, Duke researchers suggest asking a friend or colleague for a recommendation.

Researchers from the Fuqua School of Business compared patient satisfaction surveys with objective performance measures, including standardized test data from federal databases. They found that patient satisfaction scores are a better predictor of high quality hospital care than clinical performance measures.

Richard Staelin, Edward S. and Rose K. Donnell Professor at Fuqua and a co-author of the study, said the findings may surprise hospital staff who generally tend to believe that patients cannot properly assess medical treatment. Instead of focusing solely on making patients “happy” by improving food or room decor, hospitals must increase the quality of interaction between patients and hospital staff, especially nurses and physicians.

Patients may not have medical expertise about appropriate treatments, but they still offer valuable insight, said Matthew Manary, a third-year Ph.D. candidate at Fuqua and co-author of the study.

“The information they have about their experience does in fact correlate to the overall quality care the hospital provides,” he said.

Researchers evaluated the quality of care using 30-day readmission rates—which, for the study, were collected from patients who suffered heart attacks, heart failures or pneumonia. The study observed patient satisfaction surveys that included information regarding patients’ interactions with hospital staff—like whether staff provided written information about symptoms to watch out for—and questions such as, “Would you recommend this hospital to friends and family?”

Hospitals that scored well in these categories tended to have lower readmission rates. This is also to the financial advantage to hospitals because, under the Affordable Care Act, hospitals with high readmission rates will be subject to cuts in Medicare reimbursements, a Duke news release noted.

The study was a collaborative effort between medical and marketing researchers to study a statistical relationship between patient satisfaction and hospital care that was lacking in current medical research literature, Manary said. The findings were published in January’s issue of the American Journal of Managed Care.

“We aimed to merge what marketing has done in terms of figuring out customer perception with the medical literature’s focus on clinical performance and tie that into a true measure of quality, which in this case is readmission rates,” Manary said.

Staelin said although future implications of the study remain unclear, a definite causal link between patient satisfaction and hospital care could be developed through further research.

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