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Member Research & Reports

Member Research & Reports

UAB Investigates Association between Hospital Quality and Patient Satisfaction

Hospital incentive payments are increasingly becoming tied to quality. However, the U.S. health care system continues to face rising health care costs and scarce workforce resources, making improving quality a challenge. Patient satisfaction and process quality are two areas of quality tied to reimbursement—and are associated with positive health outcomes. Mr. Gabriel S. Tajeu, doctoral fellow, and Dr. Nir Menachemi, in the department of health care organization and policy at the University of Alabama at Birmingham, along with Dr. Abby S. Kazley, from the Medical University of South Carolina, recently sought to determine if there is an association between process quality (“doing the right thing”) and patient satisfaction in a representative sample of U.S. hospitals.


[Photo: Mr. Gabriel S. Tajeu]

They used a pooled cross-sectional study design with year fixed effects from 2009 to 2011, utilizing the Hospital Compare data set and the American Hospital Association Annual Survey of Hospitals (AHA) data set. The team used a method prescribed by the Joint Commission to determine hospital-level process quality in three areas: heart failure treatment, acute myocardial infarction treatment, and pneumonia treatment. They then used regression models to measure the association between process quality and two measures of overall hospital patient satisfaction.

After they controlled for hospital-level characteristics and year, the researchers found that patient satisfaction is positively associated with all three areas of hospital process quality. For example, acute myocardial infarction process quality was positively associated with whether patients “would definitely recommend the hospital.” Process quality areas were moderately and positively correlated, and on average, patient satisfaction scores have increased over time.

Study findings of an association between process quality and patient satisfaction suggest that focusing on process quality may not have negative implications for patient satisfaction. As performance in different process quality areas is only moderately correlated, Mr. Tajeu and Dr. Menachemi concluded that managers should continually monitor all areas of process quality. They recommend that the trend of increased patient satisfaction over time—perhaps because of industry pressures—should be investigated further. “Do Hospitals that Do the Right Thing Have More Satisfied Patients?” was published in June in Health Care Management Review.

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