Do hospital patient satisfaction scores reflect surgical quality?

There is a positive correlation between hospital performance on the HCAHPS patient satisfaction survey and objective measures of surgical quality, according to a study published in JAMA Surgery.

A group of researchers set out to see if patient satisfaction "is an accurate marker of high-quality surgical care." To do so, they conducted an observational study of 180 hospitals participating in the American College of Surgeons National Surgical Quality Improvement Project. They looked at hospitals' 30-day postoperative mortality, major and minor complications, failure to rescue and hospital readmission rates and grouped hospitals by quartile based on their HCAHPS scores.

When compared to hospitals in the lowest quartile of HCAHPS performance, those in the highest quartile had significantly lower risk-adjusted odds of death, failure to rescue and minor complications.

"Our findings suggest that payment policies that incentivize better patient experience do not require hospitals to sacrifice performance on other quality measures," they concluded.

This is contrary to what some other recent reports have hypothesized about the effect of incentivizing patient experience. For instance, a report from The Hastings Center, a nonpartisan research institution dedicated to bioethics, argued that emphasizing patient experience instead of outcomes "may lead healthcare astray, undermining the provision of optimum care for all."

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