Patient satisfaction is in the eye of the beholder -- patients
have widely differing expectations when they go to the hospital,
and may therefore perceive the same interactions differently. Age
differences seem to alter people's perceptions of their patient
experiences. These differences impact patient satisfaction
scores.
Gallup's 2003 patient database, which contains tens of thousands
of patient satisfaction surveys from approximately 400 hospitals
for inpatient, outpatient surgery, outpatient test and treatment,
and emergency department services, provides specific insight on how
people of different ages view their healthcare experiences.
Emergency Department
Gallup examined 130,000 patient ratings of satisfaction with the
emergency department, looking at how the mean scores for each of
seven age groups differ from the overall mean patient satisfaction
scores.
There is a direct relationship between emergency department
satisfaction and age, with the four youngest age groups (patients
under 45) each averaging below the overall mean and the three
oldest age groups averaging above the mean. Patients between the
ages of 18 and 25 have the lowest satisfaction (.10 below the mean)
and patients aged 65 and older have the highest satisfaction (.16
above the mean).
Outpatient Surgery
Emergency department facilities provide urgent, unplanned care,
while outpatient surgery procedures are usually scheduled in
advance. Despite the differing nature of these two services,
outpatient surgery satisfaction by age follows a similar pattern to
emergency department satisfaction by age, although the variation
between age groups is not as great. Again, 18- to 25-year-olds are
least satisfied at .07 below the mean. Patients between 56 and 65
years of age are most satisfied at .02 above the mean.
Outpatient surgery has the highest level of patient satisfaction
among the four areas, while the emergency department receives the
lowest satisfaction scores. This relationship may help explain why
outpatient surgery receives more consistent satisfaction scores
across all age groups. The planned nature of outpatient surgery
services may help providers to provide a higher level of care to
all patients, regardless of age.
Outpatient Test and Treatment
Outpatient test and treatment satisfaction by age also follows a
pattern similar to that of the emergency department and outpatient
surgery. Scores for patients in the middle age groups (those
between the ages of 36 and 55) do not differ significantly from the
overall mean scores, and patients over 56 score .03 above the mean.
In this area, the lowest rating comes from patients under 18 -- .9
below the mean. (For these patients, Gallup conducts interviews
with a guardian or other person familiar with the patient's
treatment.)
Inpatient
Inpatient satisfaction breaks the mold when broken down by age.
Patients between the ages of 18 and 35 are the most
satisfied (.07 above the mean for 18- to 25-year-olds, .03 above
the mean for 26- to 35-year-olds), and patients between the ages of
36 and 55 are the least satisfied (.05 below the
mean).
The high level of satisfaction among inpatients between the ages
of 18 and 35 could be explained by the high percentage of women of
childbearing age in that group. Women in childbirth make up a
significant proportion of inpatients in their 20s and 30s, and my
experience has suggested that obstetrical patients tend to have
above average satisfaction with their inpatient experiences.
Bottom Line
These results do not indicate that patients of different ages
receive different standards of care. Rather, patients of different
ages have different expectations when they enter the hospital. Many
older patients came of age in an era when doctor's orders were
followed without question. But younger patients, who grew up in an
age of healthcare consumerism, may tend to question their doctors
more and have higher expectations of service. Healthcare
organizations need to understand and anticipate the varying
expectations of different age populations and modify their services
accordingly.
Patient satisfaction scores by age also underscore the
importance of ensuring a representative sample of all age groups
when measuring satisfaction. If older patients (who are often more
likely to respond to surveys) are over-represented in a survey
sample, the scores may appear to be unrealistically high.
