Article

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: 2.01). 09/1999; 50(8):1053-8.
Source: PubMed

ABSTRACT 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.

0 Bookmarks
 · 
56 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: To be empowered, consumers must provide feedback on services so that modifications can be made. The most frequently used method to attain such information is consumer satisfaction measures. However, often the measures are not useful because they have a strong positive response bias or because they do not contain items that reflect consumer needs. An alternative brief unstructured assessment was piloted with individuals served by four Community Treatment Teams in Delaware. The high number of needs expressed suggests that further work should be done in this area.
    Community Mental Health Journal 09/2002; 38(4):277-86. · 1.03 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study used hierarchical linear models to analyze post-discharge data among 17,130 veterans who received inpatient VA mental health services between 1995 and 2001, in order to determine whether changes in mental health service affected inpatient satisfaction. In models without covariants, half the satisfaction measures increased while the other half indicated no significant change. After adjusting for changes in patient characteristics, however, nine measures indicated no change and seven showed significant declines. Demonstrating the importance of risk-adjustment, satisfaction appeared to increase over time prior to risk adjustment, but declined after adjusting for changes in patient characteristics that were associated with patient satisfaction.
    Administration and Policy in Mental Health and Mental Health Services Research 08/2004; 31(6):465-81. · 3.44 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: ABSTRACT Introduction: Similarly to the observed in other diseases, the patient’s satisfaction with his or her treatment may determine better outcomes of the chronic kidney disease (CKD). Aim: To assess the satisfaction of patients with the interdisciplinary care delivered in a Clinic of secondary prevention of CKD. Methods: The satisfaction assessment was applied to patients of the PREVENRIM – Interdisciplinary Program of Prevention of CKD. The diagnosis and staging of CKD were done as proposed by the KDOQI of the American NKF. The satisfaction assessment was made through questions covering the logistic of the Clinic, the importance of each members of the team in the management of the disease, the dynamic of the interdisciplinary care, and the understanding of the information on CKD. Results: The questionnaire were applied to 101 patients, followed for 32,66 ± 18,17 months, 52,6% were male and the mean age was 56±13,9 years. Incomplete basic education was observed in 43,8% of the patients. The main cause of CKD was hypertensive nephroesclerosis. The mean estimated GFR was 31,59±15,02mL/min/1,73m2. The great majority (95,6%) of the patients reported to be satisfied with the explanation given about their disease. Regarding the management of their disease, the patients considered important or very important the role played by nephrologists and dietician (100%), social worker and nurse (95,6%), and psychologist (97,7%). All the patients would refer patients with CKD to the PREVENRIM. Conclusion: In this group of patients with CKD not yet on dialysis, followed by an interdisciplinary team, we observed a high satisfaction level with the health care received. Future studies should assess if the level of patients’ satisfaction with their treatment will determine better outcomes in CKD.
    Jornal Brasileiro de Nefrologia 01/2008; 30(2-2175-8239):151-156.