Patient Satisfaction and Administrative Measures as Indicators of the Quality of Mental Health Care

Veterans Administration Northeast Program Evaluation Center, West Haven, CT 06516, USA.
Psychiatric Services (Impact Factor: 2.41). 09/1999; 50(8):1053-8. DOI: 10.1176/ps.50.8.1053
Source: PubMed


Although measures of consumer satisfaction are increasingly used to supplement administrative measures in assessing quality of care, little is known about the association between these two types of indicators. This study examined the association between these measures at both an individual and a hospital level.
A satisfaction questionnaire was mailed to veterans discharged during a three-month period from 121 Veterans Administration inpatient psychiatric units; 5,542 responded, for a 37 percent response rate. These data were merged with data from administrative utilization files. Random regression analysis was used to determine the association between satisfaction and administrative measures of quality for subsequent outpatient follow-up.
At the patient level, satisfaction with several aspects of service delivery was associated with fewer readmissions and fewer days readmitted. Better alliance with inpatient staff was associated with higher administrative measures of rates of follow-up, promptness of follow-up, and continuity of outpatient care, as well as with longer stay for the initial hospitalization. At the hospital level, only one association between satisfaction and administrative measures was statistically significant. Hospitals where patients expressed greater satisfaction with their alliance with outpatient staff had higher scores on administrative measures of promptness and continuity of follow-up.
The associations between patient satisfaction and administrative measures of quality at the individual level support the idea that these measures address a common underlying construct. The attenuation of the associations at the hospital level suggests that neither type can stand alone as a measure of quality across institutions.

10 Reads
  • Source
    • "Several studies could demonstrate a relationship between patient satisfaction and eff ectiveness of a treatment (Druss et al. 1999). Th erefore, the assessment of patient satisfaction is an important criterion in evaluation of psychiatric and psychotherapeutic services (Hansson 2001; Lasalvia and Ruggeri 2007). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objects: Patient satisfaction with psychiatric treatment has emerged as an important factor with respect to the quality of health care. Methods: Patient satisfaction using the Zurich Satisfaction Questionnaire (ZUF-8) as well as symptom severity (measured with the Hamilton Depression Scale [HRSD], Brief Psychiatric Rating Scale and Clinical Global Impression Scale) was assessed at admission and discharge of inpatient treatment in patients with a major depressive episode (MDD, N = 217) and schizophrenia (N = 75). Differences between the two diagnostic groups (using T-tests) and correlations of patient satisfaction with different social and treatment variables were calculated (Pearson product-moment correlation). Results: The mean score of patient satisfaction was 26.8 points (ZUF-8; range 8-32 points), without differences between MDD and schizophrenia (t = 0.45, p = 0.78). Patients with MDD and personality disorder showed lower satisfaction than patients with MDD without personality disorder (t = 2.31, p = 0.03). Patient satisfaction correlated negatively with severity of depressive symptoms at discharge (HRSD: r = - 0.38; p < 0.01) and number of comorbidities (r = - 0.42; p < 0.01) in MDD. Number of prescribed drugs correlated negatively with patient satisfaction in both groups (depression: r = - 0.28, p = 0.02; schizophrenia: r = - 0.24; p = 0.03). Conclusions: Patient satisfaction was high without differences between MDD and schizophrenia. Severity of disease and comorbidites in MDD and number of prescribed drugs in both groups were related with reduced patient satisfaction.
    International Journal of Psychiatry in Clinical Practice 11/2014; 19(2):1-16. DOI:10.3109/13651501.2014.988272 · 1.39 Impact Factor
  • Source
    • "For example, mental health users who are satisfied cooperate better with their doctors and are more accepting of treatment recommendations than users who are dissatisfied with their treatment (Druss et al. 1999). In contrast, dissatisfaction of service users with various aspects of mental health treatment increases the likelihood of treatment dropout (Berghofer et al. 2002; Druss et al. 1999; Ruggeri et al. 2007; Tehrani et al. 1996; Tempier et al. 2002). Their dissatisfaction is often based on unmet treatment expectations (Berghofer et al. 2006; Wiersma and van Busschbach 2001). "

  • Source
    • "For example, we successfully enrolled and obtained data from 79.20 % (n = 240) of those who, following the initial assessment, were deemed eligible (n = 303), and only 17.41 % (n = 51) of those deemed eligible for enrollment refused to participate. In contrast, a response rate of only 37 % was achieved in several prior investigations in which a treatment satisfaction survey was mailed to patients recently discharged from a VA psychiatric unit (Druss et al. 1999; Greenberg and Rosenheck 2004; Rosenheck et al. 1997). Patients' perceptions of the quality of care received may or may not mirror the technical quality of care, and we were not able to validate patients' ratings of their care against objective data, such as clinical outcomes. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Consumers' satisfaction with inpatient mental health care is recognized as a key quality indicator that prospectively predicts functional and clinical outcomes. Coercive treatment experience is a frequently cited source of dissatisfaction with inpatient care, yet more research is needed to understand the factors that influence consumers' perceptions of coercion and its effects on satisfaction, including potential "downstream" effects of past coercive events on current treatment satisfaction. The current study examined associations between objective and subjective indices of coercive treatments and patients' satisfaction with care in a psychiatric inpatient sample (N = 240). Lower satisfaction ratings were independently associated with three coercive treatment variables: current involuntary admission, perceived coercion during current admission, and self-reported history of being refused a requested medication. Albeit preliminary, these results document associations between patients' satisfaction ratings and their subjective experiences of coercion during both current and prior hospitalizations.
    Community Mental Health Journal 09/2012; 49(4). DOI:10.1007/s10597-012-9539-5 · 1.03 Impact Factor
Show more


10 Reads
Available from