Despite the decrease observed in visits to the emergency department
among patients satisfied with their health care use, spending and overall
outcomes, patient satisfaction was associated with increased inpatient use,
mortality and drug expenditures. The findings were published in Archives of
“Our findings raise concerns that efforts to satisfy patients may
have downsides if they lead to unnecessary care that comes with health risks
without benefits,” Joshua J. Fenton, MD, MPH, of the University of
California, Davis, told O&P Business News’ sister publication,
For the prospective cohort study, Fenton and colleagues pooled data on
51,946 adults included in the national Medical Expenditure Panel Survey between
2000 and 2007. Patient satisfaction was assessed during the first year; health
care utilization and expenditures during the second year; and mortality during
an average follow-up of 3.9 years.
Compared with patients in the lowest satisfaction quartile, patients in
the highest satisfaction quartile were less likely to visit the emergency
department more likely to be admitted to the hospital had 8.8% greater total
expenditures (95% CI, 1.6-16.6); 9.1% greater prescription drug expenditures
and higher mortality.
“[Patients] should be satisfied with doctors who provide timely,
personalized care and advice in an empathic way,” Fenton said.
“Patients who are satisfied with doctors who provide requested tests or
treatments may be in danger of getting over-tested, over-treated or
inappropriately treated with potential risks and no benefits.
“Evaluating patient satisfaction is a very important practice for
health care institutions, and patients should be satisfied with the care they
receive,” he said. “Striving for patient satisfaction, however,
should not overpower the doctor–patient relationship. A weakness of most
health systems in the United States is that doctors do not have enough time to
do this, even though it could have huge health benefits while also reducing
costs. We also need to establish wise policies — including physician
incentive policies — so that patient satisfaction is not the sole driver
of quality improvement.”
For more information:
Fenton JJ. Arch Intern
Disclosure: The researchers have no relevant financial disclosures.