The number of inpatient consultations is negatively correlated with patient satisfaction in patients with prolonged hospital stays

Abstract

Background Patient satisfaction is often measured using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey. Our aim was to examine the structural and clinical determinants of satisfaction among inpatients with prolonged lengths of stays (LOS). Methods Adult patients who were admitted between 2009 and 2012, had a LOS ≥ 21 days, and completed the HCAHPS survey were included. Univariate analyses assessed the relationship between satisfaction and patient/system variables. Recursive partitioning was used to examine the relative importance of the identified variables. Results 101 patients met inclusion criteria. The average LOS was 35 days and 58% were admitted to a surgical service. Satisfaction with physician communication was significantly associated with fewer consultations (p<0.01), non-operative admission (p<.001), no ICU stay (p<.01), non-surgical service (p<.01), and non-ER admissions (p=.03). Among these, having fewer consultations had the highest relative importance. Conclusions In long stay patients, having fewer inpatient consultations was the strongest predictor of patient satisfaction with physician communication. This suggests that examination of patient-level data in clinically relevant subgroups may be a useful way to identify targets for quality improvement.

The use of hospital consumer assessment of healthcare services and the Press Ganey medical practice surveys in guiding surgical patient care practices

“…[ 7 ] However, continuity of care has been linked to improved outcome measures, including a trend toward decreased rehospitalizations and fewer emergency room visits within 1 month of discharge. [ 8 ] In a study by Moore et al .,[ 8 ] half of all the patients studied had at least one medical error related to discontinuity of care when transitioning from the inpatient to outpatient setting. Alternatively, the implementation of a hospitalist model has shown to significantly improve outcomes inpatient care.…”

“…Alternatively, the implementation of a hospitalist model has shown to significantly improve outcomes inpatient care. [ 8 ] This model can be translated to postoperative care for neurosurgical patients. At our institution, resident physicians played a large role in the perioperative and postoperative planning process and had to sign out complex plans to less-informed mid-level providers.…”

“…Two commonly used surveys, including the Hospital Consumer Assessment of Healthcare Services (H-CAHPS) and the Press Ganey Medical Practice Survey, are useful to quantify abstract and complex concepts. [ 1 , 3 , 4 , 8 ] Utilizing both H-CAHPS and Press Ganey satisfaction surveys, we aimed to determine whether the mode of healthcare delivery was affected when mid-level providers or neurosurgical resident physicians saw patients and staffed them with attending physicians.…”

Satisfaction with surgeon care as measured by the Surgery-CAHPS survey is not related to NSQIP outcomes

“…23 In addition, previous work has examined elements of patient satisfaction aa composite and continuous variables, and these trends related to determinants of satisfaction. 24,25…”

Level of satisfaction of the patients discharged from General Surgery Service of the Hospital Nacional in 2018

“…En las estadías prolongadas (>21 días) se ha visto que la satisfacción es mayor cuanto menor sea el número de interconsultas recibido por el paciente. La causa no se conoce bien pero la experiencia en un hospital pero se cree que el interconsultor no demuestra buena comunicación y provee información contradictoria (34) . Pero también es sabido que a mayor duración de la internación es mayor el desarraigo del paciente de su hogar.…”