Associations between hospital characteristics and patient satisfaction in Germany.

BACKGROUND

The patient perspective is increasingly recognized as a central pillar of quality in hospital care. International evidence suggests that an array of interacting factors may influence patient satisfaction with hospital care, whereas only a few studies have examined the impact of hospital characteristics.

OBJECTIVE

To explore which hospital characteristics exert an influence on patient satisfaction with inpatient care.

DESIGN

Cross-sectional study using secondary data.

SETTING AND PARTICIPANTS

A total of 999 hospitals in Germany with 300 200 patient surveys from 2013 formed the study population. Patient satisfaction was surveyed using the Patients' Experience Questionnaire, and hospital characteristics were extracted from mandatory quality reports. Only hospitals with at least 75 surveys were included in the analysis.

MAIN VARIABLES STUDIED AND MAIN OUTCOME MEASURES

Four dimensions of patient satisfaction (medical care, nursing care, organization and overall impression) were studied as the outcome measures. Region, profit orientation, size, staffing per bed and quality scores were considered possible influencing hospital characteristics. We performed risk-adjusted multivariate analyses.

RESULTS

All of the characteristics had a significant influence on the patient satisfaction dimensions (P<.05), and patients in East Germany, in small hospitals or in not-for-profit hospitals, were more satisfied. Additionally, more staffing per bed as well as a better process and outcome quality were associated with more satisfied patients.

CONCLUSION

Structural and quality characteristics of hospitals have a significant impact on patient satisfaction. This association confirms that patients are sensitive to important hospital quality measures and reinforces the consideration of patient satisfaction as an indicator of the quality of care.