back

Shivaji, Ediyattumangalam R.
Public concerns about rising health costs and deteriorating quality of service in the US have become a serious issue. The Institute of Medicine (IOM)1 report brought out the need for overhauling the US Healthcare thoroughly. This report recommended that healthcare executives
should focus on performance improvement, driven by process, data, and evidence rather than relying on technology or working harder. Healthcare organizations face multiple objectives and constraints, while implementing performance improvement,.

The design of the current study was nonexperimental and the study analyzed available archival data on patient satisfaction, process of care quality measures and outcome of care measures. The study tested nine research hypotheses about the relationships between these measures. The study also brought out the main components contributing to patient satisfaction and process of care quality measures. The study used the public data on US hospitals, downloaded from the CMS database, maintained by the Center for Medicare and Medicaid services, a federal government agency. Data from over 4,500 hospitals were used in the analysis.

The major findings are summarized as follows:
  1. Five components of patient satisfaction were identified and the implications to hospitals were discussed.
  2. Nine research hypotheses were tested, and the evidence was mixed.
  3. Mean outcome rates in Church owned hospitals were significantly better than the other seven groups and definitely not worse. 1 IOM. (2001) Crossing the Quality Chasm: A New Health System for the 21st Century. Committee on Quality of Health Care in America, Institute of Medicine. 
  4. Evidence was mixed for negative association between patient satisfaction and outcomes.
  5. Evidence was mixed for negative association between process of care quality and outcomes.
The study found some empirical evidence for encouraging hospitals to adopt the qualities “friendship, compassion, joy of serving and equanimity” advocated by the ancient Vedic physician Charaka as the prime qualities required by healthcare professionals. The study has many strengths such as identifying the principal components of satisfaction and quality, using the complete CMS data on US hospitals and obtaining some empirical evidence on the relationships between satisfaction, process-of-care quality and the outcomes. Some empirical evidence was also obtained on the need for qualities like compassion among healthcare staff. The study findings are limited by the reliability of the archival data used. Statistical
conclusion validity issues were adequately controlled during testing, by adopting diagnostic techniques. However, ambiguity of temporal precedence between outcomes and process of care quality measures is a threat to the internal validity of testing their relationship. A subsequent
larger study requiring support from CMS is proposed. The study findings will assist hospitals in their performance improvement activities.

back

search login
 


Click here to cancel

You were trying to view a protected page.
Please login to gain access or cancel to go back to the site.
User ID:  
Password:  


Forgot your password?