The relationship between patients' perception of care and measures of hospital quality and safety

Abstract

Background: The extent to which patient experiences with hospital care are related to other measures of hospital quality and safety is unknown. METHODS; We examined the relationship between Hospital Consumer Assessment of Healthcare Providers and Systems scores and technical measures of quality and safety using service-line specific data in 927 hospitals. We used data from the Hospital Quality Alliance to assess technical performance in medical and surgical processes of care and calculated Patient Safety Indicators to measure medical and surgical complication rates.

Results: The overall rating of the hospital and willingness to recommend the hospital had strong relationships with technical performance in all medical conditions and surgical care (correlation coefficients ranging from 0.15 to 0.63; p<.05 for all). Better patient experiences for each measure domain were associated with lower decubitus ulcer rates (correlations -0.17 to -0.35; p<.05 for all), and for at least some domains with each of the other assessed complications, such as infections due to medical care.

Conclusions: Patient experiences of care were related to measures of technical quality of care, supporting their validity as summary measures of hospital quality. Further study may elucidate implications of these relationships for improving hospital care.

Figure 1

Relationship between Patient's Willingness to Recommend Hospital and Hospital Quality Alliance (HQA) Composite Performance ^*Quartiles represent hospital performance in the Hospital Consumer Assessment of Healthcare Providers and Systems item of “willing to recommend hospital to others.” The mean HQA condition composite scores and standard errors are shown for each quartile