Patient satisfaction is associated with lower 30-day mortality rates

Satisfying patients may lead to higher quality of surgical care and better results. A retrospective analysis of data on older patients who underwent surgery at 180 hospitals in the U.S. found that patients treated at hospitals with higher patient satisfaction scores had lower 30-day mortality rates and fewer minor complications.

However, there was no association between patient satisfaction and readmissions or major complications.

Greg D. Sacks, MD, MPH, of the University of California, Los Angeles, and colleagues published their findings online in JAMA Surgery on June 24.

For decades, the healthcare community has debated the link between patient satisfaction and the quality of hospitals, according to the researchers. They cited several studies that found patient satisfaction was not a valid measurement when assessing quality.

Still, since the passage of the Patient Protection and Affordable Care Act five years ago, quality of care at hospitals has become a bigger issue. For instance, Sacks et al noted that the value-based purchasing program developed by the Centers for Medicare & Medicaid Services (CMS) ties reimbursement and financial incentives with hospitals’ performance on numerous quality measures.

This analysis included 103,866 patients who were at least 65 years old and underwent inpatient surgery from Dec. 2, 2004 through Dec. 31, 2008. The mean age was 75.5, and 51.5 percent of patients were female.

To assess patient satisfaction, the researchers evaluated the hospitals’ performance on the HCAHPS survey, which is used in the CMS value-based purchasing program. Recently discharged patients complete the survey, which contains 27 questions about their hospital stay.

The mean overall patient satisfaction score was 68 percent. The researchers compared hospitals and grouped them into four quartiles. The mean overall patient satisfaction score was 58.7 percent for the first quartile, 66.2 percent for the second quartile, 70.8 percent for the third quartile and 76.7 percent for the fourth quartile.

Patients treated at the highest quartile hospitals had 15 percent lower odds of death within 30 days, 18 percent lower odds of failure to rescue and 13 percent lower odds of a minor complication compared with patients treated at the lowest quartile hospitals.

“Our findings suggest that payment policies that incentivize better patient experience do not require hospitals to sacrifice performance on other quality measures,” the researchers wrote.