How do hospitalization experience and institutional characteristics influence inpatient satisfaction? A multilevel approach
Article first published online: 1 JUL 2013
© 2013 The Authors. International Journal of Health Planning and Management published by John Wiley & Sons, Ltd.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
The International Journal of Health Planning and Management
Volume 29, Issue 3, pages e247–e260, July/September 2014
How to Cite
2014), How do hospitalization experience and institutional characteristics influence inpatient satisfaction? A multilevel approach, Int J Health Plann Mgmt, 29, e247–e260. doi: 10.1002/hpm.2201, , and (
- Issue published online: 4 AUG 2014
- Article first published online: 1 JUL 2013
- Manuscript Accepted: 14 MAY 2013
- Manuscript Received: 25 MAY 2012
- patient experience;
- risk adjustment;
- voluntary discharges
Over the last several years, interest in benchmarking health services' quality—particularly patient satisfaction (PS)—across organizations has increased. Comparing patient experiences of care across hospitals requires risk adjustment to control for important differences in patient case-mix and provider characteristics. This study investigates the individual-level and organizational-level determinants of PS with public hospitals by applying hierarchical models. The analysis focuses on the effect of hospital characteristics, such as self-discharges, on overall evaluations and on across hospital variation in scores. Sociodemographics, admission mode, place of residence, hospitalization ward and continuity of care were statistically significant predictors of inpatient satisfaction. Interestingly, it was observed that hospitals with a higher percentage of Patients Leaving Against Medical Advice (PLAMA) received lower scores. The latter result suggests that the percentage of PLAMA may provide a useful measure of a hospital's inability to meet patient needs and a proxy indicator of PS with hospital care. © 2013 The Authors. International Journal of Health Planning and Management published by John Wiley & Sons, Ltd.