Investigation of the determinants of patient dissatisfaction with hospitalization.

摘要

Quality of healthcare in the United States has become a critical issue because of its importance to patients, payors, and providers who want and pay for quality healthcare. The federal government mandated that healthcare facilities receiving reimbursement from the Centers for Medicare and Medicaid provide data about the healthcare quality of their facilities. An important component in this mandate is the patients' satisfactions ratings of the quality of care that they received. Some patients are not satisfied with their care and rate the hospital accordingly.;The majority of previous studies on patient satisfaction have not concentrated on dissatisfied patients. Study results have been inconclusive, or inconsistent, in describing the dissatisfied patient. This study investigated responses to questionnaires from 4,595 patients who had been hospitalized in 2008 and found that 27.5% of them were dissatisfied. Because of the potential to effect satisfaction, this study also investigated patients' dissatisfaction with processes that can be improved.;Patients responded to questions focused on satisfaction with nursing and physician care, environment, pain management and discharge information. Demographic information was collected on age, gender, educational level, health status, diagnostic codes and race.;To determine the relationship between satisfaction and eight variables, a Pearson Chi Square analysis was conducted for each variable. A t test was conducted to determine if there was a difference in length of stay. A Kruskal-Wallis test was conducted to determine the independence between satisfaction and five variables related to satisfaction. To investigate a correlation between satisfaction and hospital recommendations, a Spearman's rho was conducted. A factor analysis was performed to determine factors that accounted for the variance in responses from satisfied and dissatisfied patients.;The analysis resulted in a description of dissatisfied patients who were female, between 18 and 34 years of age, have either a high school education or some college, are likely admitted for gynecological or obstetrical care and are white. They are not satisfied with the communication and respect from physicians or nurses, the environment and the information about medication. These issues can be improved by hospital administrators who utilize quality improvement methods resulting in fewer dissatisfied patients.