Skip to main content
CMAJ : Canadian Medical Association Journal logoLink to CMAJ : Canadian Medical Association Journal
. 1994 Jun 1;150(11):1813–1822.

How was your hospital stay? Patients' reports about their care in Canadian hospitals.

C Charles 1, M Gauld 1, L Chambers 1, B O'Brien 1, R B Haynes 1, R Labelle 1
PMCID: PMC1337056  PMID: 8199958

Abstract

OBJECTIVE: To survey adult medical and surgical patients about their concerns and satisfaction with their care in Canadian hospitals. DESIGN: Cross-sectional telephone survey undertaken from June 1991 to May 1992 with a standardized questionnaire. SETTING: Stratified random sample of public acute care hospitals in six provinces; 57 (79%) of the 72 hospitals approached agreed to participate. PATIENTS: Each participating hospital provided the study team with the names of 150 adult medical and surgical patients discharged home in consecutive order. A total of 4599 patients agreed to be interviewed (69% of eligible patients and 89% of patients contacted). MAIN OUTCOME MEASURES: Satisfaction with (a) provider-patient communication (including information given), (b) provider's respect for patient's preferences, (c) attentiveness to patient's physical care needs, (d) education of patient regarding medication and tests, (e) quality of relationship between patient and physician in charge, (f) education of and communication with patient's family regarding care, (g) pain management and (h) hospital discharge planning. RESULTS: Most (61%) of the patients surveyed reported problems with 5 or fewer of the 39 specific care processes asked about in the study. Forty-one percent of the patients reported that they had not been told about the daily hospital routines. About 20% of the patients receiving medications reported that they had not been told about important side effects in a way they could understand; 20% of the patients who underwent tests reported similar problems with communication of the test results. Thirty-six percent of those having tests had not been told how much pain to expect. In discharge planning, the patients complained that they had not been told what danger signals to watch for at home (reported by 39%), when they could resume normal activities (by 32%) and what activities they could or could not do at home (by 29%). Over 90% of the patients reported that they had had a relationship of confidence and trust with their physician and that they had been involved in decision making as much as they wanted to be. Fifteen percent of the patients whose admissions had been scheduled felt that they should have been admitted sooner. CONCLUSION: The self-reported patient data from this survey suggest that hospital routines, medications, tests, pain management and discharge planning are areas of communication to target in future quality-improvement efforts in Canadian hospitals.

Full text

PDF
1813

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Carmel S. Satisfaction with hospitalization: a comparative analysis of three types of services. Soc Sci Med. 1985;21(11):1243–1249. doi: 10.1016/0277-9536(85)90273-4. [DOI] [PubMed] [Google Scholar]
  2. Cleary P. D., Edgman-Levitan S., McMullen W., Delbanco T. L. The relationship between reported problems and patient summary evaluations of hospital care. QRB Qual Rev Bull. 1992 Feb;18(2):53–59. doi: 10.1016/s0097-5990(16)30507-3. [DOI] [PubMed] [Google Scholar]
  3. Cleary P. D., Edgman-Levitan S., Roberts M., Moloney T. W., McMullen W., Walker J. D., Delbanco T. L. Patients evaluate their hospital care: a national survey. Health Aff (Millwood) 1991 Winter;10(4):254–267. doi: 10.1377/hlthaff.10.4.254. [DOI] [PubMed] [Google Scholar]
  4. Cleary P. D., Keroy L., Karapanos G., McMullen W. Patient assessments of hospital care. QRB Qual Rev Bull. 1989 Jun;15(6):172–179. doi: 10.1016/s0097-5990(16)30288-3. [DOI] [PubMed] [Google Scholar]
  5. Cleary P. D., McNeil B. J. Patient satisfaction as an indicator of quality care. Inquiry. 1988 Spring;25(1):25–36. [PubMed] [Google Scholar]
  6. Donabedian A. Evaluating the quality of medical care. Milbank Mem Fund Q. 1966 Jul;44(3 Suppl):166–206. [PubMed] [Google Scholar]
  7. Fitzpatrick R. Surveys of patient satisfaction: II--Designing a questionnaire and conducting a survey. BMJ. 1991 May 11;302(6785):1129–1132. doi: 10.1136/bmj.302.6785.1129. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Fitzpatrick R. Surveys of patients satisfaction: I--Important general considerations. BMJ. 1991 Apr 13;302(6781):887–889. doi: 10.1136/bmj.302.6781.887. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Fleming G. V. Hospital structure and consumer satisfaction. Health Serv Res. 1981 Spring;16(1):43–63. [PMC free article] [PubMed] [Google Scholar]
  10. Goupy F., Ruhlmann O., Paris O., Thélot B. Results of a comparative study of in-patient satisfaction in eight hospitals in the Paris region. Qual Assur Health Care. 1991;3(4):309–315. doi: 10.1093/intqhc/3.4.309. [DOI] [PubMed] [Google Scholar]
  11. Hall J. A., Dornan M. C. Patient sociodemographic characteristics as predictors of satisfaction with medical care: a meta-analysis. Soc Sci Med. 1990;30(7):811–818. doi: 10.1016/0277-9536(90)90205-7. [DOI] [PubMed] [Google Scholar]
  12. Hall J. A., Dornan M. C. What patients like about their medical care and how often they are asked: a meta-analysis of the satisfaction literature. Soc Sci Med. 1988;27(9):935–939. doi: 10.1016/0277-9536(88)90284-5. [DOI] [PubMed] [Google Scholar]
  13. Hall J. A., Milburn M. A., Epstein A. M. A causal model of health status and satisfaction with medical care. Med Care. 1993 Jan;31(1):84–94. doi: 10.1097/00005650-199301000-00007. [DOI] [PubMed] [Google Scholar]
  14. Hsieh M. O., Kagle J. D. Understanding patient satisfaction and dissatisfaction with health care. Health Soc Work. 1991 Nov;16(4):281–290. doi: 10.1093/hsw/16.4.281. [DOI] [PubMed] [Google Scholar]
  15. Linn L. S., Greenfield S. Patient suffering and patient satisfaction among the chronically ill. Med Care. 1982 Apr;20(4):425–431. doi: 10.1097/00005650-198204000-00007. [DOI] [PubMed] [Google Scholar]
  16. Locker D., Dunt D. Theoretical and methodological issues in sociological studies of consumer satisfaction with medical care. Soc Sci Med. 1978 Jul;12(4A):283–292. [PubMed] [Google Scholar]
  17. Meterko M., Rubin H. R. Patient judgments of hospital quality. A taxonomy. Med Care. 1990 Sep;28(9 Suppl):S10–S14. doi: 10.1097/00005650-199009001-00003. [DOI] [PubMed] [Google Scholar]
  18. Nelson C. W., Niederberger J. Patient satisfaction surveys: an opportunity for total quality improvement. Hosp Health Serv Adm. 1990 Fall;35(3):409–427. [PubMed] [Google Scholar]
  19. Nelson E. C., Hays R. D., Larson C., Batalden P. B. The patient judgment system: reliability and validity. QRB Qual Rev Bull. 1989 Jun;15(6):185–191. doi: 10.1016/s0097-5990(16)30290-1. [DOI] [PubMed] [Google Scholar]
  20. Oberst M. T. Methodology in behavioral and psychosocial cancer research. Patients' perceptions of care. Measurement of quality and satisfaction. Cancer. 1984 May 15;53(10 Suppl):2366–2375. [PubMed] [Google Scholar]
  21. Pascoe G. C., Attkisson C. C. The evaluation ranking scale: a new methodology for assessing satisfaction. Eval Program Plann. 1983;6(3-4):335–347. doi: 10.1016/0149-7189(83)90013-7. [DOI] [PubMed] [Google Scholar]
  22. Pascoe G. C. Patient satisfaction in primary health care: a literature review and analysis. Eval Program Plann. 1983;6(3-4):185–210. doi: 10.1016/0149-7189(83)90002-2. [DOI] [PubMed] [Google Scholar]
  23. Rubin H. R. Can patients evaluate the quality of hospital care? Med Care Rev. 1990 Fall;47(3):267–326. doi: 10.1177/107755879004700302. [DOI] [PubMed] [Google Scholar]
  24. Rubin H. R. Patient evaluations of hospital care. A review of the literature. Med Care. 1990 Sep;28(9 Suppl):S3–S9. doi: 10.1097/00005650-199009001-00002. [DOI] [PubMed] [Google Scholar]
  25. Vuori H. Patient satisfaction--does it matter? Qual Assur Health Care. 1991;3(3):183–189. doi: 10.1093/intqhc/3.3.183. [DOI] [PubMed] [Google Scholar]
  26. Ware J. E., Jr, Berwick D. M. Patient judgments of hospital quality. Conclusions and recommendations. Med Care. 1990 Sep;28(9 Suppl):S39–S44. [PubMed] [Google Scholar]
  27. Ware J. E., Jr, Davies-Avery A., Stewart A. L. The measurement and meaning of patient satisfaction. Health Med Care Serv Rev. 1978 Jan-Feb;1(1):1, 3-15. [PubMed] [Google Scholar]
  28. Ware J. E., Jr, Snyder M. K., Wright W. R., Davies A. R. Defining and measuring patient satisfaction with medical care. Eval Program Plann. 1983;6(3-4):247–263. doi: 10.1016/0149-7189(83)90005-8. [DOI] [PubMed] [Google Scholar]
  29. Williams S. J., Calnan M. Convergence and divergence: assessing criteria of consumer satisfaction across general practice, dental and hospital care settings. Soc Sci Med. 1991;33(6):707–716. doi: 10.1016/0277-9536(91)90025-8. [DOI] [PubMed] [Google Scholar]
  30. Zastowny T. R., Roghmann K. J., Hengst A. Satisfaction with medical care: replications and theoretic reevaluation. Med Care. 1983 Mar;21(3):294–322. doi: 10.1097/00005650-198303000-00004. [DOI] [PubMed] [Google Scholar]

Articles from CMAJ: Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association

RESOURCES