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Patient satisfaction associated with lower emergency department use but more hospitalisations and higher costs and mortality
  1. Matthew L Maciejewski1,2,
  2. Jeffrey S Harman3
  1. 1Durham VA Medical Center, Center for Health Services Research in Primary Care, Durham, North Carolina, USA
  2. 2Department of Medicine, Duke University, Durham, North Carolina, USA
  3. 3Department of Health Services Research, Management and Policy, University of Florida, Gainesville, Florida, USA
  1. Correspondence to: Dr Matthew L Maciejewski
    Center for Health Services Research in Primary Care, 508 Fulton Street, Durham, NC 27705, USA; mlm34{at}

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With the ascent of patient-centred medical homes and accountable care organisations in the USA, patient satisfaction is being seen as an outcome that should be elevated to a performance measure on par with the process of care. Health systems are encouraged to be patient-centred, and patients are encouraged to be consumers and choose providers on the basis of satisfaction (and other) metrics. It is expected that lower publicly reported satisfaction scores will motivate hospitals to improve care quality and patient satisfaction to retain the market share. The potential power of patient satisfaction is currently being tested by the Centers for Medicare and Medicaid Services, which created the Hospital Compare website in 2005 to enable Medicare beneficiaries to compare hospitals by patient …

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  • Competing interests None.