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Patient Satisfaction Linked to Varied Health Care Utilization

Higher patient satisfaction is associated with less emergency department use, but with greater inpatient admissions, expenditures, and higher mortality, according to a study published online Feb. 13 in the Archives of Internal Medicine.

Joshua J. Fenton, M.D., M.P.H., of the University of California-Davis in Sacramento, and colleagues conducted a prospective analysis of 36,428 participants of a subsample of the 2000 to 2007 Medical Expenditure Panel Survey to determine how year-one patient satisfaction scores related to year-two health care utilization and expenditures and to mortality, during a mean follow-up of 3.9 years.

After adjusting for confounding variables, the researchers found that, compared to respondents in the lowest quartile, respondents in the highest quartile for patient satisfaction were less likely to visit an emergency department (adjusted odds ratio [aOR], 0.92). However, they did have higher odds for any inpatient admission (aOR, 1.12), as well as 8.8 percent increased expenditures, 9.1 percent increased prescription drug costs, and increased mortality (adjusted hazard ratio, 1.26).

"These associations warrant cautious interpretation and further evaluation, but they suggest that we may not fully understand the factors associated with patient satisfaction," the authors write. "Without additional measures to ensure that care is evidence based and patient centered, an overemphasis on patient satisfaction could have unintended adverse effects on health care utilization, expenditures, and outcomes."

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