Patient satisfaction influences mortality after AMI

12 March 2010

MedWire News: Patient satisfaction with their care after acute myocardial infarction (AMI) is closely associated with in-hospital mortality, say researchers who make specific recommendations for improving satisfaction.

Many hospitals now routinely question patients about the care they received. In the US, patient-satisfaction data from standardized, nationwide surveys was made available to the public in 2008.

However, the determinants of patient satisfaction and the relationship between satisfaction and clinical outcomes remains unclear, write Seth Glickman (University of North Carolina, Chapel Hill, USA) and colleagues in the journal Circulation: Cardiovascular Quality and Outcomes.

To investigate further, Glickman and team used data from the CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the American College of Cardiology/American Heart Association Guidelines) Registry.

Specifically, the investigators studied data on clinical care and patient satisfaction from 3562 individuals who had suffered AMI and were treated at one of 25 US hospitals over a 5-year period.

Analysis revealed that patient satisfaction was closely linked to 13 of the 14 measures of AMI clinical performance.

Indeed, even after controlling for how closely a hospital adhered to care guidelines, increased patient satisfaction remained significantly associated with decreased risk for in-hospital mortality. Specifically, each quartile increase in either patient satisfaction or guideline adherence produced the same improvement in odds of survival.

Interestingly, standard of nursing care was found to be the single most important determinant of overall patient satisfaction, “highlighting an important area for further quality improvement efforts and underscoring the role of the entire health care team in the in-hospital treatment of patients with AMI,” the authors comment.

Concluding, the authors point out that this is the first study to associate patient satisfaction and mortality after adjusting for clinical quality.

Overall, the researchers say that their findings show that “increasing the patient satisfaction score is less about making the patients ‘happy’ by, for example, improving the food or room decor, and more about increasing the quality of care and the interactions between patients and staff, particularly interactions with nurses and physicians.”

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Circ Cardiovasc Qual Outcomes 2010; Advance online publication