Skip to main content
SpringerLink
Log in

Are older patients more satisfied with hospital care than younger patients?

  • Original Articles
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

Abstract

OBJECTIVE: Determine relationships between age, self-reported health, and satisfaction in a large cohort of hospitalized patients.

DESIGN: Cross-sectional survey.

SETTING: Thirty-one hospitals in a large Midwestern metropolitan area.

PATIENTS/PARTICIPATION: Randomly selected medical and surgical patients (N=64,900; mean age, 61 years; 56% female; 84% white) discharged during specific time periods from July 1990 to March 1995 who responded to a mailed survey (overall response rate, 48%).

MEASUREMENTS AND MAIN RESULTS: Patients’ overall ratings of hospital quality and satisfaction with 5 aspects of care (physician care, nursing care, information provided, discharge instructions, and coordination of care) were measured by a validated survey, which was mailed to patients after discharge. Analyses compared satisfaction in 5 age groups (18 to 35, 36 to 50, 51 to 65, 66 to 80, and >80 years). Scores for the 5 aspects of care initially increased with age (P<.001) and then declined (P<.001). A similar relationship was found in analyses of the proportion of patients who rated overall quality as “excellent” or “very good.” Satisfaction was also higher in patients with better self-reported health (P<.001). In analyses of patients with poor to fair health, satisfaction scores peaked at age 65 before declining. However, for patients with good to excellent health, scores peaked at age 80. Moreover, declines in satisfaction in older patients were lower in patients with better health. These findings were consistent in multivariable analyses adjusting for potential confounders.

CONCLUSIONS: Satisfaction exhibits a complex relationship with age, with scores increasing until age 65 to 80 and then declining. This relationship was consistent across individual satisfaction scales, but was modified by health status. The results suggest that age and health status should be taken into account when interpreting patient satisfaction data.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Weisman CS, Nathanson CA. Professional satisfaction and client outcomes: a comparative organizational analysis. Med Care. 1985;23:1179–92.

    Article  PubMed  CAS  Google Scholar 

  2. Linn MW, Linn BS, Stein SR. Satisfaction with ambulatory care and compliance in older patients. Med Care. 1982;20:606–14.

    Article  PubMed  CAS  Google Scholar 

  3. Francis V, Korsch BM, Morris MJ. Gaps in doctor-patient communication: patients’ response to medical advice. N Engl J Med. 1969;280:535–40.

    Article  PubMed  CAS  Google Scholar 

  4. Zastowny TR, Roghmann KJ, Hengst A. Satisfaction with medical care: replications and theoretic reevaluation. Med Care. 1982;21:294–322.

    Article  Google Scholar 

  5. Marquis MS, Davies AR, Ware JE. Patient satisfaction and change in medical care provider: a longitudinal study. Med Care. 1983;21:821–9.

    Article  PubMed  CAS  Google Scholar 

  6. Rubin HR, Gandek B, Rogers WH, Kosinski M, McHorney CA, Ware JE. Patients’ ratings of outpatient visits in different practice settings. JAMA. 1993;270:835–40.

    Article  PubMed  CAS  Google Scholar 

  7. Nelson EC, Hays RD, Larson C, Batalden PB. The patient judgment system: reliability and validity. QRB Qual Rev Bull. 1989;15:185–91.

    PubMed  CAS  Google Scholar 

  8. Gold M, Wooldridge J. Surveying consumer satisfaction to assess managed-care quality: current practices. Health Care Finance Rev. 1995;16:155–73.

    CAS  Google Scholar 

  9. Dull VT, Lansky D, Davis N. Evaluating a patient satisfaction survey for maximum benefit. Jt Comm J Qual Improv. 1994;20:444–53.

    PubMed  CAS  Google Scholar 

  10. Fox JG, Storms DM. A different approach to sociodemographic predictors of satisfaction with health care. Soc Sci Med. 1981;15A:557–64.

    Google Scholar 

  11. Cleary PD, Edgman-Levitan S, Roberts M, et al. Patients evaluate their hospital care: a national survey. Health Aff (Millwood). 1991;10:254–67.

    Article  CAS  Google Scholar 

  12. Young GJ, Meterko M, Desai KR. Patient satisfaction with hospital care. Med Care. 2000;38:325–34.

    Article  PubMed  CAS  Google Scholar 

  13. Tucker JL, Kelley VA. The influence of patient sociodemographic characteristics on patient satisfaction. Mil Med. 2000;165:72–6.

    PubMed  Google Scholar 

  14. Zaslavsky AM, Zaborski L, Cleary PD. Does the effect of respondent characteristics on consumer assessment vary across health plans? Med Care Res Rev. 2000;57:379–94.

    Article  PubMed  CAS  Google Scholar 

  15. Cleary PD, Edgman-Levitan S, McMullen W, Delbanco TL. The relationship between reported problems and patient summary evaluations of hospital care. QRB Qual Rev Bull. 1992;18:53–9.

    PubMed  CAS  Google Scholar 

  16. Carmel S. Satisfaction with hospitalization: a comparative analysis of three types of services. Soc Sci Med. 1985;21:1243–9.

    Article  PubMed  CAS  Google Scholar 

  17. DiMatteo MR, Hays R. The significance of patients’ perceptions of physician conduct: a study of patient satisfaction in a family practice center. J Community Health. 1980;6:18–34.

    Article  PubMed  CAS  Google Scholar 

  18. Hall JA, Feldstein M, Fretwell MD, Rowe JW, Epstein AM. Older patients’ health status and satisfaction with medical care in an HMO population. Med Care. 1990;28:261–70.

    Article  PubMed  CAS  Google Scholar 

  19. Rosenthal GE, Harper DL. Cleveland health quality choice: a model for collaborative community-based outcomes assessment. Jt Comm J Qual Improv. 1994;20:425–42.

    PubMed  CAS  Google Scholar 

  20. Rosenthal GE, Hammar PJ, Way LE, et al. Using hospital performance data in quality improvement: the Cleveland health quality choice experience. Jt Comm J Qual Improv. 1998;24:347–60.

    PubMed  CAS  Google Scholar 

  21. Rubin HR, Ware JE, Nelson EC, Meterko M. The patient judgments of hospital quality (PJHQ) questionnaire. Med Care. 1990;28:17S-18S.

    Article  Google Scholar 

  22. Ware JE, Hays RD. Methods for measuring patient satisfaction with specific medical encounters. Med Care. 1988;26:393–402.

    Article  PubMed  Google Scholar 

  23. SAS Institute Inc. The GLM procedure. In: SAS/STAT User’s Guide, Version 6. Carey, NC: SAS Insitute, Inc.; 1989:891–996.

    Google Scholar 

  24. Jencks SF, Kay T. Do frail, disabled, poor, and very old Medicare beneficiaries have higher hospital charges? JAMA. 1987;257:198–202.

    Article  PubMed  CAS  Google Scholar 

  25. Searle SR. Linear Models. New York, NY: John Wiley and Sons Inc; 1971.

    Google Scholar 

  26. Goodsell CT. The contented older client of bureaucracy. Int J Aging Hum Dev. 1981–82;14:1–9.

    Article  PubMed  Google Scholar 

  27. Lee Y, Kasper JD. Assessment of medical care by elderly people: general satisfaction and physician quality. Health Serv Res. 1998;32:741–57.

    PubMed  CAS  Google Scholar 

  28. Linder-Pelz S. Toward a theory of patient satisfaction. Soc Sci Med. 1982;16:577–82.

    Article  PubMed  CAS  Google Scholar 

  29. Linder-Pelz S. Social psychological determinants of patient satisfaction: a test of five hypotheses. Soc Sci Med. 1982;16:583–9.

    Article  PubMed  CAS  Google Scholar 

  30. Like R, Zyzanski SJ. Patient satisfaction with the clinical encounter: social psychological determinants. Soc Sci Med. 1987;24:351–7.

    Article  PubMed  CAS  Google Scholar 

  31. Hall JA, Milburn MA, Epstein AM. A causal model of health status and satisfaction with medical care. Med Care. 1993;31:84–94.

    Article  PubMed  CAS  Google Scholar 

  32. Lasek RJ, Barkley W, Harper DL, Rosenthal GE. An evaluation of the impact of nonresponse bias on patient satisfaction surveys. Med Care. 1997;35:646–52.

    Article  PubMed  CAS  Google Scholar 

  33. Finkelstein BS, Harper DL, Rosenthal GE. Patient assessments of hospital maternity care: a useful tool for consumers. Health Serv Res. 1999;34:623–40.

    PubMed  CAS  Google Scholar 

  34. McDowell I, Newell C. Measuring Health: A Guide to Rating Scales and Questionnaires, 2nd ed. New York: Oxford University Press; 1996.

    Google Scholar 

  35. Covinsky KE, Rosenthal GE, Chren M, et al. The relation between health status changes and patient satisfaction in older hospitalized medical patients. J Gen Intern Med. 1998;13:223–9.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of General Internal Medicine, University of Iowa Hospitals and Clinics, SE618 GH, 200 Hawkins Dr., 52242, Iowa City, IA

    C. Komal Jaipaul MD &  Gary E. Rosenthal MD

Authors
  1. C. Komal Jaipaul MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gary E. Rosenthal MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gary E. Rosenthal MD.

Additional information

Received from Medicine Service, Iowa City VA Medical Center, and the Division of General Internal Medicine, Department of Internal Medicine, University of Iowa, Iowa City, Iowa.

Dr. Jaipaul was supported by a fellowship from the VA National Quality Scholars Program, Office of Academic Affiliations, Department of Veterans Affairs, Dr. Rosenthal is a Senior Quality Scholar, Office of Academic Affiliations, Department of Veterans Affairs.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jaipaul, C.K., Rosenthal, G.E. Are older patients more satisfied with hospital care than younger patients?. J GEN INTERN MED 18, 23–30 (2003). https://doi.org/10.1046/j.1525-1497.2003.20114.x

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1046/j.1525-1497.2003.20114.x

Key words

Search

Navigation