Few cross-sectional studies have reported an association between patient satisfaction, a metric for performance-based hospital reimbursement, and catheter-associated bloodstream infections (CLABSI), but the persistence of this relationship over time has not been examined. Therefore, our aim in this study was to examine this relationship over a 4-year period using data from almost all hospitals in the United States.
We used the publicly accessible Hospital Compare website to extract data on hospital characteristics, hospital-level CLABSI and patient satisfaction scores (Hospital Compare Consumer Assessment of Healthcare Providers and Systems survey data) from 2011 to 2014. Mixed linear regression models were used to examine the relationship between the four domains of satisfaction scores (included in models separately) and observed to expected CLABSI ratio without and with adjustment for hospital ownership, availability of emergency services, nurse to bed ratio, resident to bed ratio, total number of beds, total number of physicians, and urban versus rural status.
Of the 3528 hospitals (12396 observations) with patient satisfaction data, CLABSI data were available for 2129 hospitals. The mean (SD) CLABSI ratio was 0.54 (0.56), patient satisfaction with physician and nurse communication were 80.2% (4.4%) and 77.3% (4.9%) respectively; 70%(9.1%) of patients recommended a hospital and 68.8% (8.0%) rated a hospital 9 or 10 (on a 1-10 scale). Over 4 years, CLABSI scores decreased each year (-0.02, 95%CI=-0.03 to -0.01) while satisfaction scores increased (physicians: 0.16, 95%CI=0.12 to 0.19; nurses: 0.56, 95%CI=0.52 to 0.60; hospital recommendation:0.18, 95%CI=0.12 to 0.23; hospital rating: 0.56, 95%CI=0.50 to 0.62). In adjusted models, higher CLABSI ratios were associated with lower satisfaction with physician (-0.09, 95%CI=-0.17 to -0.01) and nurse (-0.12, 95%CI=-0.21 to -0.02) communication. In contrast, CLABSI ratios were not associated with hospital recommendation (-0.09, 95%CI=-0.22 to 0.04) or rating (-0.07, 95%CI=-0.21 to 0.06).
In this first longitudinal study of most hospitals in the United States, hospitals with higher CLABSI ratios had lower patient satisfaction with physician and nurse communication but not with hospital recommendation or rating.
R. Qayyum, None