Objective: To determine the impact of adjusting for rating tendency (RT) on patient satisfaction scores in a large teaching hospital and to assess the impact of adjustment on the ranking of divisions.
Design: Cross-sectional survey.
Setting: Large 2200-bed university teaching hospital.
Participants: All adult patients hospitalized during a 1-month period in one of 20 medical divisions.
Intervention: None.
Main outcome measures: Patient experience of care measured by the Picker Patient Experience questionnaire and RT scores.
Results: Problem scores were weakly but significantly associated with RT. Division ranking was slightly modified in RT adjusted models. Division ranking changed substantially in case-mix adjusted models.
Conclusions: Adjusting patient self-reported problem scores for RT did impact ranking of divisions, although marginally. Further studies are needed to determine the impact of RT when comparing different institutions, particularly across inter-cultural settings, where the difference in RT may be more substantial.
Keywords: case-mix adjustment; patient satisfaction; rating tendency; survey.
© The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.