Patient Satisfaction as a Reflection of Quality Health Care and Outcomes

Background: In 2006 the Centers of Medicaid and Medicare Services mandated that acute care centers begin submitting HCAHPS survey data for financial reimbursement for Medicare patients. The national shift to a patient centered focus and the financial incentive to improve patient satisfaction scores has stimulated debate regarding the relationship between patient satisfaction and quality healthcare. Clinical Question: Does improvement in patient satisfaction with their healthcare and its providers, as measured by the HCAHPS survey, improve healthcare quality and outcomes? Design: Systematic literature review. Methods: Searches were performed using PubMed and Scopus databases.The terms used for the PubMed search were “patient satisfaction” and “HCAHPS” with filters for full text, last 10 years and English. The terms for the Scopus search were “quality”, “patient satisfaction” and “care” with filters for English, from 2010 and “Limit Exact Keyword ‘patient satisfaction’.” Results: The PubMed search found two articles: Jha et al., and Kennedy et. al. Another study was located in PubMed using “frequently viewed together” hyperlink: Fenton, et al. The Scopus database search located an additional two articles: Lyu et a.l, and Tsai et al. Conclusions: The relationship between patient satisfaction and healthcare quality remains elusive. Within this review, two articles showed a positive association, one showed a negative association and two that supported the null hypothesis. Limitations to the HCAHPS survey and various quality assessment tools prevent the adequate assessment regarding the association between patient satisfaction and healthcare quality. Further refinement of the HCAHPS and quality assessment tools are required to help determine a more concrete relationship.