Does Doctor–Patient Communication Affect Patient Satisfaction with Hospital Care? Results of an Analysis with a Novel Instrumental Variable

Abstract

The primary outcome was patients' ratings of their overall satisfaction with hospital care, and the primary independent variable was patients' ratings of their physicians' communication behaviors. To remove possible confounding of the association between patient ratings of physician communication and overall satisfaction by other patient-specific attributes, we created an instrumental variable (IV) in a two-stage linear regression. The IV was the mean of the communication ratings given to each physician by the other patients cared for by that physician. PRINCIPLE FINDINGS/CONCLUSIONS: Three thousand one hundred and twenty-three patients were included in the analysis. In the ordinary least squares regression, there was a significant positive relationship between overall satisfaction and overall ratings of attendings' communication behaviors, with an increase in overall satisfaction of 0.58 points on a 5-point scale for each 1-point increase in overall attendings' communication behaviors, p<.001. This relationship was maintained but attenuated in the IV regression, with a coefficient of 0.40, p=.046. Although we find that the relationship between patient communication ratings and overall patient satisfaction may be confounded by patient-level factors, we nevertheless continue to find evidence of a statistically significant and sizable relationship between physicians' communication behaviors and overall patient satisfaction after controlling for such factors.

Applying Instructor Communication Behaviors and Learning Outcomes to the Pediatrician-Parent Context

“…Interestingly, the interaction between pediatrician verbal receptivity and parent health literacy moderated all parent learning outcomes (i.e., communication satisfaction, affective learning, and cognitive learning). These findings are consistent with those of other researchers who have examined the impact of physicians' use of verbal receptivity behaviors (e.g., displaying empathy, letting the patient speak, and encouraging patients to ask questions) on positive patient outcomes (Clever et al, 2008). Wanzer and colleagues (2004) found that physician, nurse, and staff displays of empathy, listening, and other positive verbal behaviors were significant predictors of parents' satisfaction with health care in a large children's hospital.…”

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