Trends in Patient Satisfaction

With pay-for-performance and value-based purchasing programs focusing on patient experience of care, providers are almost desperately trying to understand how to achieve and maintain the high scores necessary to avoid negative reimbursement impacts.  A report from vendor Press Ganey gives trends over the last five years in patient satisfaction scores, by type of provider, and identifies patients’ top areas for improvement.  The report also looks at employee and physician issues, which can be critical in improving patient satisfaction    (Press Ganey Report)   Using a mix of publicly available data and some proprietary information from the company, the report generally found that clinical and patient satisfaction scores in all clinical settings had improved over the last five years.

Looking at CMS’ clinical measures for hospitals, as well as HCAHPS and the value-based purchasing measures, the report finds a strong correlation in performance on all three areas and also a large gap between the best performers and the worst.  In general, large hospitals have lower scores, as do not-for-profits and teaching hospitals.  Southern hospitals tend to have higher scores.  Hospitals with the highest HCAHPS scores had the best profit margins.  Compliance with evidence-based standards of care is high, so further improvement and distinguishing among hospitals may be difficult.  Hospital patients’ priorities include responsiveness to concerns and emotional needs.  Patients admitted through the ER tend to have lower satisfaction scores, so that could be a focus for improvement.  In regard to outpatient services, older patients tend to be more satisfied, as do women.

Even ER satisfaction has increased.  Patients’ main concern, as might be expected, relates to wait times and to accurate information about those times.  Patients coming in in the late afternoon and beyond have lower satisfaction than those arriving during the day.  Employee job satisfaction is key to patient satisfaction and there is room for improvement.  Employees want recognition and to be listened to.  Older employees tend to be more engaged than younger ones.  Patients tend to have high satisfaction with their physicians; a big negative factor is wait times.  Home care satisfaction is strongly tied to the performance of the specific nurse or aide and how requests for changes in those staff are handled.  For all of the complaints that are voiced about the US health system, satisfaction is actually very high, much better than for most industries.