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Patient satisfaction and value based purchasing in hospitals, Odisha, India.
Woskie, Liana; Kalita, Anuska; Bose, Bijetri; Chakraborty, Arpita; Gupta, Kirti; Yip, Winnie.
Affiliation
  • Woskie L; Department of Community Health, Tufts University, 574 Boston Ave, Suite 208, MedfordMA02155, United States of America (USA).
  • Kalita A; Department of Global Health and Population, Harvard University, Boston, USA.
  • Bose B; Department of Global Health and Population, Harvard University, Boston, USA.
  • Chakraborty A; Oxford Policy Management India Pvt Ltd, New Delhi, India.
  • Gupta K; Oxford Policy Management India Pvt Ltd, New Delhi, India.
  • Yip W; Department of Global Health and Population, Harvard University, Boston, USA.
Bull World Health Organ ; 102(7): 509-520, 2024 Jul 01.
Article in En | MEDLINE | ID: mdl-38933484
ABSTRACT

Objective:

To examine how a general inpatient satisfaction survey functions as a hospital performance measure.

Methods:

We conducted a mixed-methods pilot study of the Hospital Consumer Assessment of Health Providers and Systems survey in Odisha, India. We divided the study into three

steps:

cognitive testing of the survey, item testing with exploratory factor analysis and content validity indexing. Cognitive testing involved 50 participants discussing their interpretation of survey items. The survey was then administered to 507 inpatients across five public hospitals in Odisha, followed by exploratory factor analysis. Finally, we interviewed 15 individuals to evaluate the content validity of the survey items.

Findings:

Cognitive testing revealed that six out of 18 survey questions were not consistently understood within the Odisha inpatient setting, highlighting issues around responsibilities for care. Exploratory factor analysis identified a six-factor structure explaining 66.7% of the variance. Regression models showed that interpersonal care from doctors and nurses had the strongest association with overall satisfaction. An assessment of differential item functioning revealed that patients with a socially marginalized caste reported higher disrespectful care, though this did not translate into differences in reported satisfaction. Content validity indexing suggested that discordance between experiences of disrespectful care and satisfaction ratings might be due to low patient expectations.

Conclusion:

Using satisfaction ratings without nuanced approaches in value-based purchasing programmes may mask poor-quality interpersonal services, particularly for historically marginalized patients. Surveys should be designed to accurately capture true levels of dissatisfaction, ensuring that patient concerns are not hidden.
Subject(s)

Full text: 1 Database: MEDLINE Main subject: Patient Satisfaction / Value-Based Purchasing Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: En Journal: Bull World Health Organ Year: 2024 Type: Article

Full text: 1 Database: MEDLINE Main subject: Patient Satisfaction / Value-Based Purchasing Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: En Journal: Bull World Health Organ Year: 2024 Type: Article