Do hospitals with lower mortality have higher patient satisfaction? A regional analysis of patients with medical diagnoses.

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.