Unhappy With Your Hospital? You Might Still Be Getting Great Care

New Methodology for Measuring Patient Quality

Article ID: 608289

Released: 30-Sep-2013 1:00 PM EDT

Source Newsroom: Thomas Jefferson University

Newswise — (PHILADELPHIA) - Thomas Jefferson University is releasing a study that re-examines the role of patient satisfaction in measuring hospital quality. Patient satisfaction scores are both intrinsically important and also help to determine hospital reimbursement rates. However, they may not be the best gauge of a good hospital. The study will appear next week in Risk Management and Insurance Review; contact Jefferson for an advance copy.

Factors such as the noise in a hospital room or the responsiveness of a nurse are critically important to patients. But these same factors are more likely to characterize a large, busy urban hospital—busy because of high caseloads. Numerous studies have linked high caseloads to better medical outcomes.

“Patients who have chronic conditions like heart failure should go to large hospitals that treat a lot of other patients with heart failure,” said the study’s lead author, Robert D. Lieberthal, Ph.D., Assistant Professor in the Jefferson School of Population Health.

“There is a lot of information patients can use to select a hospital,” said Dr. Lieberthal. “However, this is usually a laundry list of indicators that may not mean much for the lay person or that they may be unaware even exists. Our method compares hospitals directly, so that a patient choosing between two or three hospitals can easily compare them and choose the highest quality facility.”

Dr. Lieberthal has refined an existing statistical methodology known as the PRIDIT to gauge hospital quality. Dr. Lieberthal’s model was developed to establish a steady, predictable scale for hospital quality so that actuaries could map out reimbursement rates over years for programs like Medicare and the Patient Protection Affordable Care Act. Drastic, year-to-year changes in scores would make it difficult to predict reimbursement rates—and large, complex hospitals rarely improve or worsen in a meaningful way in a short time. The method for scoring hospital quality includes indicators such as patient satisfaction and medical outcomes and is weighted heavily by factors including patient mortality rates and the number of beds at the hospital. (More beds indicates more cases and better outcomes.)

Under the Lieberthal model, a patient in a highly-rated hospital might dislike the noise and bad food, but survive his life-threatening heart attack.

“Based on this study, the hospitals that have the best survival outcomes are not doing the best job of satisfying patients,” said Dr. Lieberthal.

Thomas Jefferson University (TJU), the largest freestanding academic medical center in Philadelphia, is nationally renowned for medical and health sciences education and innovative research. Founded in 1824, TJU includes Jefferson Medical College (JMC), one of the largest private medical schools in the country and ranked among the nation’s best medical schools by U.S. News & World Report, and the Jefferson Schools of Nursing, Pharmacy, Health Professions, Population Health and the Graduate School of Biomedical Sciences. Jefferson University Physicians is TJU’s multi-specialty physician practice consisting of the full-time faculty of JMC. Thomas Jefferson University partners with its clinical affiliate, Thomas Jefferson University Hospitals.

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