The correlation between patient satisfaction scores, publicly available ratings, and clinical outcomes has been studied by many researchers, but they do not come to a consensus. Some say there is a positive correlation, while others say no.
Research from 2008 suggested that patient satisfaction is associated with improved treatment outcomes and correlated with higher quality hospital care “for all…conditions measured.” The researchers used data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) for the study reported in the New England Journal of Medicine.
“Patients’ ratings of hospital care are of interest because they are, in many ways, ‘the bottom line,’” the researchers said.
Hospitals received a rating of 9 or 10 from 63% of their patients and a rating or 7 or higher from 89%, the study report says. Only a small percentage of patients were seriously dissatisfied, the researchers wrote, but very few hospitals received the highest ratings from 90% or more of their patients.
There was a “moderate” relationship between the ratio of nurses-to-patient days and patients’ experiences in the hospital, they found. The researchers reported a stronger relationship between patient satisfaction and quality.
“We found a positive relationship between patients’ experiences and the quality of clinical care in U.S. hospitals. Although the differences in quality between hospitals that received high ratings on the HCAHPS survey and hospitals that received low ratings were not large, care was consistently better in the hospitals that received high ratings across all conditions independently of other covariates measured,” they reported. “Our findings suggest that there is no need for tradeoffs between these two areas of performance.”
(The full study is available online at http://bit.ly/2d7hTOf.)
Website Ratings in Doubt
On the other hand, 2011 research from the University of Maryland’s Robert H. Smith School of Business found no evidence associating online physician satisfaction ratings with clinical quality measures. The researchers used a sample of 1,299 physicians who completed an American Board of Internal Medicine Hypertension or Diabetes Practice Improvement Module between July 1, 2011, and November 30, 2012.
They used medical record abstractions and other data to determine overall and intermediate outcomes, and they obtained physician ratings from eight publicly available health-based websites. The researchers normalized the physician website ratings by dividing each rating by the website’s maximum score.
The associations between physician website ratings and clinical quality measures (QMs) were small and statistically insignificant.
“We found no evidence that physician website ratings were associated with clinical QMs. We did find a statistically significant, but small, association between physician website ratings and 2 Practice Improvement Module measures of patient experience,” the study says. “Overall, the weak associations we found could have resulted from the low number of website ratings per physician or because patients whose ratings are reported on websites are not typical of the overall population of patients treated by the physicians in our sample.”
(The full study is available online at http://bit.ly/11U5zVO.)
In another study, researchers found that patient reports of clinical experience may differ significantly from what the surgeon reported. Surgeons and their patients individually reported surgical complications and their severity after spinal surgery.
“When patients reported complications, their surgeons also reported one only 29% of the time. Furthermore, 61% of the patients for whom surgeons reported a complication did not report a complication themselves. In other words, patients and their surgeons had very poor agreement on the fundamental question of whether the same surgery had resulted in a complication.” (The study is available online at http://bit.ly/2cCCTKW.)