by
Carol Ko, Staff Writer | January 27, 2014
From the January 2014 issue of HealthCare Business News magazine
Hospitals serving lower-income areas that are already not out to make a profit may fall even further behind if their patient satisfaction scores can’t compete with swankier facilities modeled after the Marriott.
Lip service
The question becomes even thornier as experts delve further into the causal relationship between patient satisfaction and patient outcome. One doesn’t necessarily follow from the other, it turns out.
For at least some patients, amenities are actually more important than their quality of medical care. Researchers from the Hospital Consumer Assessment of Healthcare Providers and Systems examined data on Los Angeles-area Medicare patients who needed hospital treatment for pneumonia between 2000 and 2004.
It turns out that many of them chose not to go to the hospital closest to them, but the ones they did pick weren’t necessarily the ones with the best “risk-adjusted rates of death” — meaning they were drawn to other positives that weren’t tied to clinical outcomes or proximity.
The researchers also cited a recent survey published in the New England Journal of Medicine that found patients believe that a hospital’s “nonclinical experience” matters twice as much as its “clinical reputation.”
And in 2012, a team of UC Davis researchers published a troubling study that found that people who are the most satisfied with their doctors are more likely to be hospitalized, accumulate more health care costs, and actually have higher death rates than patients who are less satisfied with their care.
For every 100 people who died over an average period of nearly four years in the least satisfied group, about 126 people died in the most satisfied group.
While it may seem radically counter-intuitive that patient satisfaction and positive patient outcomes could potentially be so far apart, researchers blame at least part of it on a knowledge gap — traditional measures of clinical quality are often hard for laypeople to understand. “Consumers may be making choices on the basis of amenities because they are easier to understand,” researchers at the Hospital Consumer Assessment of Healthcare Providers and Systems wrote.
A free market economist might argue that such scores do what they’re supposed to do: give patients what they want. But it’s unclear whether patients who are unduly influenced by amenities are making an informed choice, or whether they would choose differently if they were properly educated and informed on quality of care when evaluating hospitals.
