An article in Modern Healthcare's Aug. 15 issue by Rich Daly (“Unsatisfactory marks”) raises some troubling objections to patient satisfaction as a legitimate quality indicator. The objections are nothing new. However, given that the CMS will soon tie reimbursements to quality scores that include patient satisfaction, the doubts need to be laid to rest.
Essentially, the article suggests that patient satisfaction scores are “biased” in that “high marks for perceptions of care may have little connection to high quality clinical outcomes.” Well-respected medical centers with high “quality” scores and reputations may have low satisfaction ratings.
Daly correctly notes that patient satisfaction scores vary by hospital size and region. Scores for larger hospitals tend to be lower than those for smaller hospitals, while Northeastern hospitals tend to score lower than those in the South and Midwest. However, some researchers dismiss the relevance of lower satisfaction scores for academic medical centers in the North by suggesting that they have a preponderance of patients “with either depression or complex and serious illnesses.” Intentionally or not, this comes across as saying that patients have to be either emotionally disturbed or very sick not to recognize “the high quality of the clinical care that other measures have found those institutions provide.” Thus, patient satisfaction surveys are “biased.”