WHAT INFLUENCES PATIENTS REPORTS OF 3 ASPECTS OF HOSPITAL SERVICES

OBJECTIVES. Market forces make it essential to know what policies and actions influence patients' reports of hospital services. No studies h ave examined the role of patient characteristics, labor quality and st aff characteristics, nonlabor resources, managerial practices, and emp loyee attitudes within a single investigation. METHODS. The authors co llected, simultaneously, data about labor, management and service proc esses, nonlabor resources, and employee attitudes on 117 nonintensive medical-surgical inpatient units in 17 hospitals selected from a pool of 69 institutions within a metropolitan area by a stratified random s ample. Of the 2,595 patients who agreed to participate, 2,051 (79%) co mpleted telephone interviews regarding their experiences with physical care, education, and pain management services within 26 days of hospi tal discharge. RESULTS. A significant amount of variation in patients' service reports was explained (adjusted R(2)=0.41 physical care, 0.35 pain management, 0.44 education). Although the predictors varied for each service report, patient characteristics, especially those related to personal resources, had a large explanatory role. A labor assignme nt pattern that could explain why earlier studies found labor quality and staff characteristics to have only a weak role in the prediction o f patients' service reports was noted. CONCLUSIONS. The results relate d to patient characteristics may indicate opportunities to improve car e by confronting service design strategies that erroneously rely on a homogeneous patient population. Measurement challenges identified by t his study must be addressed to determine the role of labor quantity an d staff characteristics.