Organizational performance impacting patient satisfaction in Ontario hospitals: a multilevel analysis

BMC Research Notes

Walter P Wodchis¹  Anna J Koné Péfoyo² 

[1] Institute for Clinical Evaluative Sciences, Toronto, Canada;Cancer Care Ontario, Toronto, Canada

关键词: Multilevel model;    Quality of care;    Determinants of satisfaction;    Organizational performance;    Experience of care;    Patient satisfaction;   

Others  :  1140594
DOI  :  10.1186/1756-0500-6-509

 received in 2013-08-07, accepted in 2013-11-27,  发布年份 2013

【 摘 要 】

Background

Patient satisfaction in health care constitutes an important component of organizational performance in the hospital setting. Satisfaction measures have been developed and used to evaluate and improve hospital performance, quality of care and physician practice. In order to direct improvement strategies, it is necessary to evaluate both individual and organizational factors that can impact patients’ perception of care. The study aims were to determine the dimensions of patient satisfaction, and to analyze the individual and organizational determinants of satisfaction dimensions in hospitals.

Methods

We used patient and hospital survey data as well as administrative data collected for a 2008 public hospital report in Ontario, Canada. We evaluated the clustering of patient survey items with exploratory factor analysis and derived plausible dimensions of satisfaction. A two-level multivariate model was fitted to analyze the determinants of satisfaction.

Results

We found eight satisfaction factors, with acceptable to good level of loadings and good reliability. More than 95% of variation in patient satisfaction scores was attributable to patient-level variation, with less than 5% attributable to hospital-level variation. The hierarchical models explain 5 to 17% of variation at the patient level and up to 52% of variation between hospitals. Individual patient characteristics had the strongest association with all dimensions of satisfaction. Few organizational performance indicators are associated with patient satisfaction and significant determinants differ according to the satisfaction dimension.

Conclusions

The research findings highlight the importance of adjusting for both patient-level and organization-level characteristics when evaluating patient satisfaction. Better understanding and measurement of organization-level activities and processes associated with patient satisfaction could contribute to improved satisfaction ratings and care quality.

【 授权许可】

   
2013 Koné Péfoyo and Wodchis; licensee BioMed Central Ltd.

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