The paper is the first to show that patient satisfaction affects actual hospital choices in a large sample. Because patient satisfaction ratings are also correlated with other quality measures, the findings suggest a pathway through which individuals naturally gravitate toward higher-quality care.

No abstract

This study examined the satisfaction of family members with the end-of-life care their loved ones received. Data were collected from 1,839 individuals receiving care from 17 different care agencies nationwide. Although family satisfaction with hospice care was generally quite high. situational factors played a role. The timing of the referral was critical, with families rating services lower almost across the board when the referral to hospice was deemed "too late." Additionally, families expressed greater satisfaction when the patient's care was overseen by the hospice director, rather than a personal physician. Each of these findings has important implications for physicians, patients, and families as they begin to plan for end-of-life care.

Publicly reported process quality measures were no longer associated with outcomes, but higher patient perspectives of care were associated with lower heart failure readmissions. These associations support continued reevaluation of these measures and increased emphasis on patient experience and outcomes, as planned for Value-Based Purchasing.

This study investigates the relation among prenatal maternal resources (including intellectual ability, cognitive readiness for parenting, personal adjustment and social support), maternal perceptions about parenting and children's temperament when children were 6 months of age, and individual differences in the adaptation of 90 adolescent mothers 3 years after the birth of their first child. It was hypothesized that adolescent mothers¿ pre-existing resources and emerging perceptions about parenting determine not only their children's but also their own later adaptation to critical life events. Maternal resources uniquely predicted later maternal cognitive functioning, personal adjustment, and child abuse potential, whereas maternal perceptions uniquely predicted maternal demographic status 3 years after childbirth. Moreover, maternal perceptions were found to mediate the influence of maternal resources on parent-child interactional styles. The unique roles that maternal resources and perceptions played in determining later maternal functioning are discussed.