Patient satisfaction with hospital care provided by hospitalists and primary care physicians

Authors

  • Adrianne Seiler MD,

    Corresponding author
    1. Division of Healthcare Quality, Baystate Medical Center, Springfield, Massachusetts
    2. Division of Hospital Medicine, Baystate Medical Center, Springfield, Massachusetts
    3. Division of General Medicine, Tufts University School of Medicine, Boston, Massachusetts
    • Division of Hospital Medicine, Baystate Medical Center, 759 Chestnut St, Springfield, MA 01199
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    • Tel.: 413-794-4320; Fax: 413-794-1767

  • Paul Visintainer PhD,

    1. Division of Academic Affairs, Baystate Medical Center, Springfield, Massachusetts
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  • Richard Brzostek MA,

    1. Division of Customer Satisfaction and Market Research, Baystate Medical Center, Springfield, Massachusetts
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  • Michael Ehresman MBA,

    1. Division of Decision Support, Baystate Medical Center, Springfield, Massachusetts
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  • Evan Benjamin MD,

    1. Division of Healthcare Quality, Baystate Medical Center, Springfield, Massachusetts
    2. Division of General Medicine, Tufts University School of Medicine, Boston, Massachusetts
    3. Center for Quality of Care Research, Baystate Medical Center, Springfield, Massachusetts
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  • Winthrop Whitcomb MD,

    1. Division of Healthcare Quality, Baystate Medical Center, Springfield, Massachusetts
    2. Division of Hospital Medicine, Baystate Medical Center, Springfield, Massachusetts
    3. Division of General Medicine, Tufts University School of Medicine, Boston, Massachusetts
    4. Center for Quality of Care Research, Baystate Medical Center, Springfield, Massachusetts
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  • Michael B. Rothberg MD, MPH

    1. Division of General Medicine, Tufts University School of Medicine, Boston, Massachusetts
    2. Center for Quality of Care Research, Baystate Medical Center, Springfield, Massachusetts
    3. Division of General Medicine and Geriatrics, Baystate Medical Center, Springfield, Massachusetts
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  • Disclosure: Adrianne Seiler, MD, certifies that all coauthors have seen and agree with the contents of the manuscript. Paul Visintainer, PhD, had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Dr Seiler certifies that none of the authors involved in the study had any potential conflicts of interest nor financial interests. Our study had no funding or sponsorship.

Abstract

BACKGROUND:

Compared to hospital care provided by primary care physicians (PCPs), the hospitalist model provides equal-to-superior efficiency and outcomes; however, little is known about how the model affects patient satisfaction.

METHODS:

Random patient satisfaction telephone interviews were conducted on discharged adult medicine inpatients at 3 Massachusetts hospitals between 2003 and 2009. Questionnaires included variables assessing patient satisfaction with various physician care domains. Patient age, gender, admission year, education level, language, illness severity, emergency room admission status, institution, and attending physician type were extracted from billing records. We used adjusted multivariable models to compare patient satisfaction with hospitalists and PCPs for domains of: physician care quality, physician behavior, pain management, communication.

RESULTS:

Inpatients completed discharge surveys for 8295 encounters (3597 hospitalist, 4698 PCP). Multivariate-adjusted satisfaction scores for physician care quality were slightly higher for PCPs than hospitalists (4.24 vs 4.20, P = 0.04); there was no statistical difference at any individual hospital, and no difference among different hospitalist groups. Patient ratings of hospitalists and PCPs for behavior, pain control, and communication were equivalent (all P values >0.23). In multivariable models, hospitalists and PCPs had similar adjusted proportions in the highest satisfaction category (79.2% vs 80.5%, respectively, P = 0.17) and lowest category (5.1% vs 4.5%, respectively, P = 0.19). Quality ratings of both groups improved equivalently (P slope interaction = 0.47) but significantly over time (PCP 4.21 (2003) to 4.36 (2009), hospitalist 4.11 to 4.33, P Δ <0.001).

CONCLUSIONS:

Patients appear similarly satisfied with inpatient care provided by several hospitalist models and by primary care physicians. Journal of Hospital Medicine 2012;. © 2011 Society of Hospital Medicine.

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