NCPA - National Center for Policy Analysis

No Relationship between Patient Satisfaction and Surgical Quality

April 22, 2013

For the health care industry, it is important to get feedback on the quality of care being provided so improvements and modifications can be made. A new study finds that patient satisfaction, a widely used metric, may not be a good indicator of surgical quality, says Kaiser Health News.

  • Many surveys ask a recent patient about whether a doctor is a good communicator, the hospital room was clean and quiet, and pain was well controlled.
  • A new study by Johns Hopkins Medical University evaluates satisfaction and surgical quality measures at 31 hospitals in 10 states.
  • The study measures the results of standard Medicare surveys, which measure quality based on how consistently surgeons and nurses followed recommended standards of care.

The results of the study, which also considered how hospital employees evaluated safety attitudes at their hospital, show that there is little relationship between a hospital's patient satisfaction scores and quality ratings. The results also show no relationship between patient scores and hospital workers' overall assessment of the hospital's safety culture.

  • Because satisfaction surveys are among the few quality measures that are available to the public, the researchers state that the results of such patient satisfaction reports may be misconstrued.
  • The hospital with the most informative doctors and the cleanest lobby may not necessarily perform the best heart surgery, for example.
  • The Johns Hopkins study results replicate previous studies that also indicate that the relationship between patient views and quality or care is weakly correlated.

The study's results have implications for Medicare. As part of ObamaCare, Medicare is in the first year of its value-based purchasing program, which uses patient assessments to account for 30 percent of the program's bonuses and penalties. Some of the other measures of quality of care are included in the calculation of the other 70 percent of the bonuses and penalties this year.

Source: Jordan Rau, "Patient Satisfaction May Not Be A Good Indicator of Surgical Quality, Study Finds," Kaiser Health News, April 17, 2013. Heather Lyu et al., "Patient Satisfaction as a Possible Indicator of Quality Surgical Care," JAMA Surgery, April 2013.


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