Does the patient's inherent rating tendency influence reported satisfaction scores and affect division ranking?

Abstract

Objective: To determine the impact of adjusting for rating tendency (RT) on patient satisfaction scores in a large teaching hospital and to assess the impact of adjustment on the ranking of divisions. Design: Cross-sectional survey. Setting: Large 2200-bed university teaching hospital. Participants: All adult patients hospitalized during a 1-month period in one of 20 medical divisions. Intervention: None. Main Outcome Measures: Patient experience of care measured by the Picker Patient Experience questionnaire and RT scores. Results: Problem scores were weakly but significantly associated with RT. Division ranking was slightly modified in RT adjusted models. Division ranking changed substantially in case-mix adjusted models. Conclusions: Adjusting patient self-reported problem scores for RT did impact ranking of divisions, although marginally. Further studies are needed to determine the impact of RT when comparing different institutions, particularly across inter-cultural settings, where the difference in RT may be more substantial.