Jaipaul C Komal, Rosenthal Gary E
Division of General Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City 52242, USA.
Am J Med Qual. 2003 Mar-Apr;18(2):59-65. doi: 10.1177/106286060301800203.
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.
尽管患者满意度是广泛使用的质量指标，但满意度与其他指标之间的关系却鲜有研究。本研究调查了1993 - 1997年俄亥俄州东北部29家医院患者满意度与病情严重程度调整后的死亡率之间的医院层面相关性。通过对42255名随机选取的患有医学诊断疾病的患者进行有效调查，来衡量对六个护理维度的满意度。对200562名患有六种高发病症的连续患者确定了病情严重程度调整后的死亡率。分析发现满意度得分与死亡率呈负相关。在累计的五年期间，六个维度中的五个维度的相关性显著或接近显著（协调[R = -0.40；P = 0.03]，出院指导[R = -0.39；P = 0.04]，总体质量[R = -0.38；P = 0.04]，提供的信息[R = -0.37；P = 0.05]，以及护理[R = -0.35；P = 0.06]）。医生护理方面的相关性最弱（R = -0.07；P = 0.72）。这些发现表明，患者满意度较高的医院往往病情严重程度调整后的死亡率也较低。在衡量患者沟通、护理协调和护理的满意度维度上，相关性最强，而在医生护理方面相关性最弱。
