The Cost of Satisfaction

Abstract

In a nationally representative sample, higher patient satisfaction was associated with less emergency department use but with greater inpatient use, higher overall health care and prescription drug expenditures, and increased mortality.

Incentives to increase patient satisfaction: Are we doing more harm than good?

“…The most recent study involving a national sample of American patients showed that the highest level of patient satisfaction is associated with greater prescription drug costs and overall health care expenditures and 26% higher overall mortality compared with those with the lowest levels of satisfaction, even after adjusting for sociodemographics, medical comorbidities and previous health expenditures. 3 This study is supported by earlier data showing that patient satisfaction had no correlation with technical quality of care (i.e., the use of health services according to standards of care). 1,4,5 These studies all used survey-based ratings of patients' self-reported overall satisfaction with their health care encounters.…”

“…7 These confounding variables must be adjusted for when using satisfaction as a metric. In addition, definitions of satisfaction vary across studies, 1,3 leading to interpretative difficulties. Furthermore, the time between the health care encounter and the response to the questionnaire can vary, limiting the generaliz-ability of results.…”

Patient satisfaction in musculoskeletal medicine

“…In fact, there is mixed evidence that by measuring and focusing on patient satisfaction scores, some physicians may be motivated to fulfill patient desires at the expense of safety, effectiveness, or efficiency. In a large prospective cohort study of over 50,000 patients, higher patient satisfaction was associated with less emergency department use but with greater inpatient use, higher overall health care and prescription drug expenditures, and increased mortality [6]. These concerns with the untoward consequences of measuring and publishing patient satisfaction scores were outlined in a highly publicized magazine article, "Why rating your doctor is bad for your health," in 2013 [7].…”

Internet Sabotage: Negative Online Reviews of Psychiatrists

“…9 Data are collected despite the fact that high patientsatisfaction scores have been correlated with higher odds of inpatient admission, greater expenditures, and higher mortality. 10 Because of this, physicians have reported increased job dissatisfaction, job attrition, pressure to inappropriately prescribe antibiotics or narcotics, and pressure to order unnecessary tests or admissions due to concerns that they need to generate high patient-satisfaction scores. 11 Physicians are now sometimes more selective when accepting patients, avoiding high-risk patients to improve their ratings.…”