Is There a Relationship Between Patient Satisfaction and Health Care Utilization, Expenditures, and Mortality?
BACKGROUND AND PURPOSE:
Patient satisfaction is a metric used to assess health care quality
CMS requires participating health plans to publicize patient satisfaction scores and some plans use these surveys to assess physician quality and compensation
Data is limited as to whether patient satisfaction is associated with improved outcomes
Fenton et al. (JAMA Internal Medicine, 2018) assessed whether there is a relationship between patient satisfaction and health care utilization, expenditures, and outcomes
Prospective cohort study
Adult respondents to the 2000 through 2007 National Medical Expenditure Panel Survey (MEPS)
Annual national representative survey
Individuals were interviewed successively during 2 years
Year 1 patient satisfaction was assessed using 5 items from the Consumer Assessment of Health Plans Survey
Adjusted associations between Year 1 patient satisfaction and the following outcomes were estimated
Year 2 health care utilization (any emergency department visits and any inpatient admissions)
Year 2 health care expenditures (total and for prescription drugs)
Mortality during a mean follow-up duration of 3.9 years
Results adjusted for confounders
Sociodemographics | Insurance status | Availability of a usual source of care | Chronic disease burden | Health status | Year 1 utilization and expenditures
51,946 patients were included in the study
Respondents in the highest patient satisfaction quartile (relative to the lowest patient satisfaction quartile) had
Lower odds of any emergency department visit
adjusted odds ratio [aOR] 0.92; 95% CI, 0.84-1.00
Higher odds of any inpatient admission
aOR 1.12; 95% CI, 1.02-1.23
Greater total expenditures
aOR 8.8%; 95% CI, 1.6%-16.6%
Greater prescription drug expenditures
aOR 9.1%; 95% CI, 2.3%-16.4%
adjusted hazard ratio 1.26; 95% CI, 1.05-1.53
Association between high patient satisfaction and increased mortality was even greater after excluding patients with poor self-rated health and substantial chronic disease burden
Higher patient satisfaction was associated with less emergency department use but with greater inpatient use, higher overall health care, prescription drug expenditures, and increased mortality
The authors state
Without additional measures to ensure that care is evidence based and patient centered, an overemphasis on patient satisfaction could have unintended adverse effects on health care utilization, expenditures, and outcomes.
Please login to access ObGFirst and the T2 US Atlas
Media - Internet
Computer System Requirements
OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Jointly provided by
NOT ENOUGH CME HOURS
It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan