Association between resource utilization and patient satisfaction at a tertiary care medical center

BACKGROUND The Centers for Medicare and Medicaid Services has emphasized patient satisfaction as a means by which hospitals should be compared and as a component of financial reimbursement. We sought to identify whether resource utilization is associated with patient satisfaction ratings. DESIGN This was a retrospective, cohort study over a 27‐month period from January 2012 to April 2014 of adult respondents (n = 10,007) to the Hospital Consumer Assessment of Healthcare Providers and Systems survey at a tertiary care medical center. For each returned survey, we developed a resource intensity score related to the corresponding hospitalization. We calculated a raw satisfaction rating (RSR) for each returned survey. Multivariable logistic regression was used to determine the association between resource intensity and top decile RSRs, using those with the lowest resource intensity as the reference group. RESULTS Adjusting for age, gender, insurance payer, severity of illness, and clinical service, patients in higher resource intensity groups were more likely to assign top decile RSRs than the lowest resource intensity group (“moderate” [adjusted odds ratio {aOR}: 1.42, 95% confidence interval {CI}: 1.11‐1.83], “major” [aOR: 1.56, 95% CI: 1.22‐2.01], and “extreme” [aOR: 2.29, 95% CI: 1.8‐2.92]). CONCLUSIONS Resource utilization may be positively associated with patient satisfaction. These data suggest that hospitals with higher per‐patient expenditures may receive higher ratings, which could result in hospitals with higher per‐patient resource utilization appearing more attractive to healthcare consumers. Journal of Hospital Medicine 2016;11:785–791. © 2016 Society of Hospital Medicine