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Is comfort valued more than outcomes in patient satisfaction survey?

A paper released by the Hastings Center stated that the priority to improve scores on patient surveys could actually hurt improvements in quality care. Even though patient satisfaction is a vital component of care, especially in regards to respectful treatment, the use of these could have effects which are troubling to the delivery of care, according to authors Stuart J. Youngner and Alexandra Junewicz.

Three ways of understanding satisfaction.

The report finds that a big part of the problem is in the definition of the term ‘satisfaction’ which differs widely. There are three distinct ways in which patients can be satisfied. The first is in terms of improvement in outcomes and whether or not the care was deemed medically necessary. The next is in terms of whether or not the patients and their families feel they received the treatment they desired, regardless of whether or not it was medically necessary. The final definition is only superficially related to medical outcome and is in terms of how patients viewed such things as communication, convenience and treatment that was respectful. This final understanding of satisfaction is patients’ top priority.

Report finds flaws in how surveys are taken and utilised

The report found that patient satisfaction is subjective and thus everyone has a different perspective and there is no distinct relationship to the technical quality in which healthcare is administered. Instead, satisfaction is related to those qualities of healthcare that are less objective.

According to the report’s authors, the humanistic understanding, the third category, seems to be the main focus of patient satisfaction on the whole. The report also stated that most of those surveys don’t address such factors as rates of readmission, complications from surgery, infections contracted in hospital and death rates.

Surveys assign erroneous level of expertise to patients

Additionally, most surveys will ask patients to rate their doctors in terms of ‘worst’ to ‘best.’ According to Youngner and Junewicz, this assumes a level of expertise in the field that patients simply don’t have and combines satisfaction with the level of quality care.

Unfortunately, according to the authors, this is affecting the way in which doctors are tailoring treatments. Now they are working to achieve favourable responses. It is their thesis that patients must respond to surveys as consumers and not as sick people. By so doing, the satisfaction surveys will be more accurate.


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