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17-04-2013 | Surgery | Article

Happy patients no indicator of surgical quality


Free abstract

medwireNews: Patient satisfaction with their hospital stay does not inform on the quality of surgical care they received, US researchers warn.

Their study collated results for the Patient Satisfaction Survey, Centers for Medicare & Medicaid Services Surgical Care Improvement Program, and employee Safety Attitudes Questionnaire for 31 US hospitals between 2009 and 2010.

Patient satisfaction varied between 47% and 83%, averaging at 67%, but did not significantly correlate with process-of-care performance measures such as following recommended timing of prophylactic antibiotics, thromboprophylaxis, or Foley catheter removal, or appropriate hair removal.

Nor did patient satisfaction correlate significantly with the hospital's overall safety culture, or measures assessing job satisfaction, working conditions, or perception of management by individual members of staff.

However, there was a "mild" positive correlation between patient and employee team work climate and safety climates, and a significant negative correlation between patient satisfaction and employee stress recognition.

"Based on our findings, we specifically challenge the notion that a patient's level of satisfaction reported in isolation of other surgical outcome metrics reflects the quality of a surgeon's procedure or the perioperative expertise associated with their care," write Martin Makary (Johns Hopkins University, Baltimore, Maryland) and co-authors.

They therefore question the use of Consumer Assessment of Healthcare Providers and Systems Survey results as one of 26 quality measures used from 2012 by the US Department of Health and Human Services for assessing care received by Medicare patients. Patient satisfaction has also been used since 2010 for national payers.

"This study may inform new reimbursement policies being widely adopted and lead to more studies to further define the relationship between patient satisfaction and surgical outcomes," Makary et al comment

They add: "Studies defining the relationship between patient satisfaction and future outcomes data may confirm the findings of our study. This transparency will better inform patients seeking care and provide an important context for patient satisfaction scores-currently the only outcome listed for surgical services at the Hospital Compare website."

medwireNews ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

By Lynda Williams, Senior medwireNews Reporter

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