Comfort, Not Quality, Woos Patients

People are more likely to recommend a hospital based on the comfort they felt when hospitalized rather than the quality of the care they received, a new study has found.

Good food, rooms with a view, friendly nurses, peace and quiet, more television channels, and other amenities impress patients more than higher survival rates and lower hospital-acquired conditions rates.

These are among the findings from an analysis of patient satisfaction data from 3000 hospitals between 2007 and 2010.

This has long been a concern of NASH, and in the past, NASH wrote to federal regulators in response to proposals to use patient survey results in Medicare quality purchasing programs, explaining that

… we believe some of the [federal government’s] survey’s questions are biased against large urban hospitals.  We think it is inappropriate, for example, to compare the degree of quietness of a seventy-five-year-old hospital with semi-private rooms located in a congested urban area with that of a new facility with private rooms located on a sylvan, multi-acre campus set well off any major thoroughfares. 

Learn more about how inpatients view their hospital experiences and how those experiences shape how they rate hospitals in Oxford Academic’s Social Forces article “Patients as Consumers in the Market for Medicine: The Halo Effect of Hospitality” and find a summary of that analysis in the HealthLeaders Media article “Hospitality Trumps Clinical Outcomes When It Comes To Patient Satisfaction.”

Hospitals: “How’re We Doing?”

More hospitals are looking for feedback on their performance from the people who know best: their patients.

While some just continue to ask and pursue such information informally, others are going so far as to create formal patient advisory councils to offer insight on the hospital experience from the perspective of the hospital bed. Currently, more than 40 percent of hospitals have such councils.

One of the driving forces behind this surge in interest in patient satisfaction, according to USA Today, is

…is the health law’s quality-improvement provisions and other federal financial incentives, such as the link between Medicare payments and patient satisfaction scores.

Patient satisfaction is one of several factors included in Medicare’s value-based purchasing program, and in the past the National Association of Urban Hospitals (NAUH) has expressed opposition to its use. Patient satisfaction is measured by their responses to the Hospital Consumer Assessment of Health Providers and Systems (HCAHPS) survey, and in a 2012 letter to the U.S. Department of Health and Human Services, NAUH maintained that

…we believe the survey and the manner in which some of the data it generates will be weighted are biased against large urban hospitals.

iStock_000008112453XSmallAmong the reasons, NAUH noted that the typical private safety-net hospital is older than other hospitals, has more semi-private rather than private rooms, and is closer to streets and street noise than newer hospitals; the HCAHPS survey gives too little weight to the views expressed by women delivering babies and patients for whom English is not their native language; and the survey’s outcome does not reflect the quality of care a hospital provides.

Learn more about what hospitals are doing to learn how their patients view their performance and why they are going to such lengths in this USA Today article.