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July 25, 2017

Hospitals with more satisfied patients really do provide better care, research finds

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    Research suggests that hospitals with higher patient satisfaction scores might provide better care, Austin Frakt writes for the New York Times' "The Upshot."

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    Quality data concerns

    The health care industry's recent shift toward transparency and health care quality has resulted in a mass of publicly available hospital quality data—but according to Frakt, patients should be "suspicious" of how such data are measured.

    For instance, some hospitals might treat a disproportionate share of sicker individuals with worse health outcomes, which could make the hospitals seem to perform poorer on quality than they actually do. Further, according to Frakt, many measures of hospital quality fail to account for the socioeconomic status of a hospital's patient population, which could bias the results in favor of hospitals that serve higher-income areas over their counterparts in lower-income regions.

    Ashish Jha, co-author of a study on inconsistencies in health care quality measures and a scholar of health care quality at the Harvard T.H. Chan School of Public Health, said, "We have a vast number of quality measures ... but which are signal and which are noise? It can be incredibly tricky to sort out."

    Research suggest patient satisfaction could be linked with quality of care

    To address that issue, a working paper published earlier this year by the National Bureau of Economic Research set out to determine which hospital quality data is indicative of better patient outcomes.

    For the study, researchers from the Massachusetts Institute of Technology (MIT) and Vanderbilt University reviewed data spanning 2008 to 2012 on Medicare beneficiaries living within the same ZIP code who needed emergency care and were served by different ambulance companies. The researchers used the data to determine whether patient satisfaction scores were linked with hospital quality, as well as certain common indicators of quality care, such as a hospital providing a heart attack patient aspirin upon the patient's arrival.

    Joseph Doyle, an economist at MIT and a co-author of the research, said, "We found that hospitals' patient satisfaction scores are useful signals of quality," adding, "Hospitals with more satisfied patients have lower mortality rates, as well as lower readmission rates."

    When the researchers looked at common indicators of quality care, they also found a connection to lower readmission and mortality rates. For instance, the researchers found hospitals that performed the best on such measure could reduce patient mortality within a year by about 14 percent, compared with hospitals that performed the worse on such measures.

    Overall, Doyle said the finding show that although "hospital quality measures are not perfect," there are "some reasons to be optimistic about some of them." He continued, "Hospitals that score well on patient satisfaction, follow good processes of care, and record lower hospital mortality rates over the prior three years do seem to keep patients alive and out of the hospital longer" (Frakt, "The Upshot," New York Times, 7/24).

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