Patient satisfaction and administrative measures as indicators of the quality of mental health care

Objective: Although measures of consumer satisfaction are increasingly used to supplement administrative measures in assessing quality of care, little is known about the association between these two types of indicators. This study examined the association between these measures at both an individua l and a hospital level. Methods: A satisfaction questionnaire was mailed to veterans discharged during a three-month period from 121 Veterans Administ ration inpatient psychiatric units; 5,542 responded, for a 37 percent respo nse rate. These data were merged with data fi om administrative utilization files. Random regression analysis was used to determine the association be tween satisfaction and administrative measures of quality for subsequent ou tpatient follow-up. Results: At the patient level, satisfaction with severa l aspects of service delivery was associated with fewer readmissions and fe wer days readmitted. Better alliance with inpatient staff was associated wi th higher administrative measures of rates of follow-up, promptness of foll ow-up, and continuity of outpatient care, as well as with longer stay for t he initial hospitalization. At the hospital level, only one association bet ween satisfaction and administrative measures was statistically significant . Hospitals where patients expressed greater satisfaction with their allian ce with outpatient staff had higher scores on administrative measures of pr omptness and continuity of follow-up. Conclusions: The associations between patient satisfaction and administrative measures of quality at the individ ual level support the idea that these measures address a common underlying construct. The attenuation of the associations at the hospital level sugges ts that neither type can stand alone as a measure of quality across institu tions.