Measuring the Quality of Hospital Services - Hospital Specific Factors and Individual Evaluations

Fulltext 447 kb

What aspects of quality are important to consumers of hospital services? Do quality indicators, such as readmission rates and waiting time, capture the quality that consumers demand? The main empirical finding is that hospitals’ readmission rates have a negative and significant effect on inpatients’ experiences. Patients admitted to hospitals with low readmission rates are more content with the care, treatment, and information they receive from hospital personnel.

In 2002 the state took over ownership of the Norwegian hospital sector and organized it through five regional semiautonomous companies. The motivation behind this was more efficient use of hospital resources, equal access despite geographical differences and a higher quality of health services. Cost efficiency, measured as total activity relative to total costs, decreased during the 1990s. Part of the decrease can be explained by increased labour costs. It is often assumed that decreasing costs lead to lower quality. If this is the case in the health sector, one would expect to see a higher level of quality when costs per patient increase. But what aspects of quality are important to consumers of health services? Do quality indicators, such as readmission rates and waiting time, capture the quality that consumers demand? This report is an attempt to answer these questions.

The data on patient satisfaction with hospital services were taken from an anonymous survey among patients admitted to somatic hospitals, the Norwegian Patient Register. They received the surveys two to three weeks after discharge. The survey consisted of 50 questions that were grouped into seven category variables, according to the type of service the different questions concerned. Patients were also asked about their gender, age, health status, education level, number of admissions last two years, and whether their first language was Scandinavian. The main empirical finding is that hospitals’ readmission rates have a negative and significant effect on inpatients’ experiences. Patients admitted to hospitals with low readmission rates are more content with the care, treatment, and information they receive from hospital personnel. They are also more content with hospital facilities and sanitary conditions and organization of hospital staff. Patients’ age, health status, number of previous admissions, and education level significantly affected their satisfaction with hospital services. The results for waiting time were more ambiguous. Patients’ impression of hospitals’ facilities and sanitary conditions was better at hospitals with longer waiting time.

ISBN 82-7756-155-05