Newly released research has linked higher patient satisfaction scores with greater healthcare costs and increased risk of mortality. Despite the growing reliance on satisfaction scores as a tool for evaluating physician performance, “research suggests a tenuous link between patient satisfaction and healthcare quality and outcomes,” according to a study published online Feb. 13 in the Archives of Internal Medicine.

Using data from more than 50,000 patients, the authors found that those who reported the most satisfaction with their care had a 26% higher mortality risk. Those patients also had higher overall healthcare expenditures, higher drug expenditures and higher inpatient admissions. Rates of emergency department use were lower among highly satisfied patients, however, the study said.

“In combination with reduced emergency department use, increased inpatient care among the most satisfied patients raises the question of whether more satisfied patients may be differentially hospitalized for elective or less urgent indications, because non-elective urgent hospital admissions often begin with emergency department visits,” the authors said. “It is also possible that patients who are least satisfied with their physicians may be more likely to seek healthcare at emergency departments rather than at outpatient clinics.”

More research is needed to better understand the drivers of patient satisfaction, said the authors, warning that the overemphasis on such scores “could have unintended adverse effects on healthcare utilization, expenditures and outcomes.”