Koichiro Otani, PhD, Indiana University-Purdue University Fort Wayne, Fort Wayne, Indiana; Brian Waterman, Thomson Reuters Healthcare, Chicago; and W Claiborne Dunagan, MD, BJC Healthcare, St. Louis, Missouri
With increasing emphasis in healthcare on patient satisfaction, many patient satisfaction studies have been administered. Most assume that all patients combine their healthcare experiences (such as nursing care, physician care, etc.) in the same way to arrive at their satisfaction; however, no research has been conducted prior to the present study to investigate how patients' health conditions influence the way they combine their healthcare experiences. This study aims to determine how seriously ill patients differ from less seriously ill patients during their combining process.
Data were collected from five large hospitals in the St. Louis area by administering a patient satisfaction questionnaire. Multiple linear regression analyses with a scatter term, a severity measure, and interaction effects of the severity measure were conducted while controlling for age, gender, and race.
Two models (overall quality of care and willingness to recommend to others) were analyzed, and the severity of illness variable revealed interaction effects with physician care, staff care, food, and scatter term variables in the willingness to recommend model (six attributes were analyzed: admission process, nursing care, physician care, staff care, food, and room). With more seriously ill patients, physician care becomes more important and staff care becomes less important, and seriously ill patients are proportionately more likely to combine their attribute reactions only in the willingness to recommend model.
All six attributes are not equally influential. Nursing care and staff care show consistent influence in both models. These findings show that if healthcare managers want to increase their patient satisfaction, they should enhance nursing care and staff care first to experience the most improvement.
For more information about the concepts in this article, contact Dr. Otani at otanik@ipfw. edu .
Healthcare environments have been changing rapidly and drastically in the United States. Not only must healthcare managers contend with current changes, they must also anticipate future changes. One shift that has occurred in healthcare is an emphasis on patient satisfaction. Traditionally, the quality of healthcare has been measured by healthcare professionals using objective measures. But patient satisfaction is not an objective measure and may be influenced by the so-called bedside manner of caregivers. Nevertheless, patient satisfaction is gaining attention for several reasons. First, patient satisfaction is considered customer satisfaction. In any field, customer satisfaction is a key determinant of an organization's survival; healthcare is no exception. Some observers recommended that hospitals and healthcare systems go so far as to regard patients as guests (Fottler, Ford, and Heaton 2011) who are seeking not only positive clinical outcomes but also quality service experiences. Satisfied customers or patients bring business. With increasing empowerment of patients who can decide their choices of providers, patients are no longer passive (Fottler et al. 2006; Scotti, Harmon, and Behson 2007; Ford et al. 2006).
Second, managed care organizations use the patient satisfaction data to choose, negotiate with, and decide the level of bonus to pay to providers (Zimmerman, Zimmerman, and Lund 1997). In response, many studies have investigated possible measures to improve patient satisfaction at the organizational level (Powers and Jack 2008; Pink, Murray, and McKillop 2003; Marley, Collier, and Goldstein 2004; Hotchkiss, Fottler, and Unruh 2009; Fottler et al. 2000; Ford et al. 2006). Healthcare managers need to pay particular attention to their patient satisfaction data and develop the organization's competitive advantage with the positive feedback they receive. …