Satisfaction with hospitalization: a comparative analysis of three types of services.
ABSTRACT A study of patient's satisfaction with hospital services was undertaken. The purpose of the study was to explore whether and to what extent patients' satisfaction with three types of hospital services (medical, nursing and supportive) is differentially explained by patient's sociodemographic, psychosocial, situational and attitudinal characteristics. To achieve this, 476 patients were interviewed. The results of the analysis of their general satisfaction with hospitalization and a comparative analysis of satisfaction with the three types of services are presented. The best predictors of satisfaction with all three types of services (in order of their importance) are found to be: perceived improvement in health, size of social networks, satisfaction with organizations in the past, and age. The type of ward (medical vs surgical) is found to be a powerful predictor of satisfaction with physicians and nurses only. Ward effect is also interactive--improvement in one's health predicts significantly more satisfaction with medical services in medical wards than in surgical wards. The findings of this study suggest that when clients perceive that their main goal has been achieved (i.e. improvement in health), they tend to attach little importance to deficiencies in the process of achieving it (i.e. the provision of services).
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ABSTRACT: /st> To investigate the correlation between length of stay (LOS) and patient satisfaction on the level of hospital wards. The underlying hypothesis is that good quality of care leads both to shorter LOS and to patients that are more satisfied. /st> We used standardized LOS and standardized patient satisfaction data from seven specialisms: internal medicine, cardiology, pulmonology, neurology, general surgery, orthopaedic surgery and obstetrics and gynaecology in the period 2003-2010. All LOS data were derived from the National Medical Registration and patient satisfaction scores were measured by a questionnaire covering six aspects of care. The LOS data were standardized for the year of discharge, age, primary diagnosis and procedure. Patient satisfaction data were standardized for the year, age, education and health status. /st> One hundred and eighty-eight Dutch hospital wards. /st> The patient satisfaction data were gathered by questionnaires returned by 102 815 patients. /st> None. /st> Pearson correlations and two-tailed significance. between standardized mean LOS and standardized mean patient satisfaction score. /st> We found no correlation between LOS and patient satisfaction in six out of seven specialties. We only found significantly higher patient satisfaction scores in pulmonology for some specific items on hospitals wards with a shorter LOS. These items concerned the reception on the ward, the information provided by nurses on admission, the expertise of the nursing staff, the way information was transferred from one person to another and respect for patients' privacy such as in conversations, and during physical examinations. /st> We found no evidence that hospital wards with a relatively short mean LOS had higher, or lower, patient satisfaction than hospital wards with a relatively long LOS, with the exception of pulmonology.International Journal for Quality in Health Care 07/2012; 24(5):443-51. · 1.79 Impact Factor
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ABSTRACT: Current data suggests an association between elevations in interleukin 1 (IL-1)α, IL-1β, and IL-6 and the proliferation of neural progenitor cells (NPCs) following brain injury. A limited amount of work implicates changes in these pro-inflammatory responses with diminished NPC proliferation observed as a function of aging. In the current study, adolescent (21day-old) and 1year-old CD-1 male mice were injected with trimethyltin (TMT, 2.3mg/kg, i.p.) to produce acute apoptosis of hippocampal dentate granule cells. In this model, fewer 5-bromo-2'-deoxyuridine (BrdU)+ NPC were observed in both naive and injured adult hippocampus as compared to the corresponding number seen in adolescent mice. At 48h post-TMT, a similar level of neuronal death was observed across ages, yet activated ameboid microglia were observed in the adolescent and hypertrophic process-bearing microglia in the adult. IL-1α mRNA levels were elevated in the adolescent hippocampus; IL-6 mRNA levels were elevated in the adult. In subgranular zone (SGZ) isolated by laser-capture microdissection, IL-1β was detected but not elevated by TMT, IL-1a was elevated at both ages, while IL-6 was elevated only in the adult. Naïve NPCs isolated from the hippocampus expressed transcripts for IL-1R1, IL-6Rα, and gp130 with significantly higher levels of IL-6Rα mRNA in the adult. In vitro, IL-1α (150pg/ml) stimulated proliferation of adolescent NPCs; IL-6 (10ng/ml) inhibited proliferation of adolescent and adult NPCs. Microarray analysis of SGZ post-TMT indicated a prominence of IL-1a/IL-1R1 signaling in the adolescent and IL-6/gp130 signaling in the adult.Brain Behavior and Immunity 07/2011; 25(5):850-62. · 5.61 Impact Factor
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ABSTRACT: Patient reports or ratings are essential for measuring the quality of patient care. Measures designed for this purpose tend to focus on the processes and structures of care rather than the outcomes of it. The latter is arguably the most valid indicator of the quality of care patients receive. Typically this information is gathered by probing patient satisfaction with treatment as part of an investigation of satisfaction with hospital care. More recently patient ratings of the outcome of treatment have been obtained to measure treatment efficacy in clinical trials. However, a more direct approach is to ask patients to assess the benefit of treatment on their current health status. We performed a structured literature review on patient reported satisfaction with outcomes of treatment and direct patient assessments of the same. The purpose of this was to identify suitable candidate questions for a short instrument to tap patient evaluations of in-patient hospital interventions. Articles were included if they dealt with patient satisfaction or patient assessment of outcomes of treatment. Articles were excluded if they dealt more generally with patient satisfaction with care. We identified 169 papers, 79 were included in the review. The findings of this review suggest that there are a number of benefits of directly asking patients to assess the outcome of hospital treatment. Importantly this approach reflects outcomes relevant to the patient and is also more likely to reflect patient report in routine clinical practice. There is also evidence that such approaches have face validity and construct validity. The problems associated with this approach (i.e. response bias), are those common to patient reported outcome surveys, but employing appropriate strategies can minimize them. Furthermore, employing a simple set of questions that asks patients to assess outcomes of treatment they receive can be time and resource efficient in comparison to administering lengthy measures. This approach could be tested for potential generic use as an evaluative measure for patients in hospital settings.Health and Quality of Life Outcomes 01/2014; 12(1):5. · 2.27 Impact Factor