Symptoms in hospitalized patients: Outcome and satisfaction with care

PURPOSE: Physical symptoms are responsible for substantial morbidity in out patients. We assessed symptoms in patients admitted to a hospital to determ ine their frequency, persistence at discharge, and the relation between sym ptom outcome and satisfaction with care. METHODS: During a 12-month period, 2,126 hospitalized medical patients comp leted a study interview within 2 hours of admission. More than half (n = 1, 168) of the patients were re-interviewed within 24 hours of discharge. We a scertained the presence and severity of 11 physical symptoms, as well as ac tivities of daily living, mobility, mood, self-rated health, physiologic se verity of illness, satisfaction with care, and length of stay. RESULTS: Symptoms were common at the time of hospital admission, particular ly fatigue (80% of patients), dyspnea (60%), cough (51%), dizziness (51%), headache (47%), chest pain (46%), and nausea or vomiting (43%). Individual symptoms failed to resolve by hospital discharge approximately 25% to 50% o f the time. The three most prominent predictors of persistence of symptoms were shorter length of stay, severity of the symptom on admission, and tota l symptom count. Patient satisfaction with care was associated with total s ymptom severity score at discharge and the degree of symptomatic improvemen t that had occurred during hospitalization. CONCLUSION: Because symptoms are common at discharge and associated with de creased satisfaction with care, asking about them would be a reasonable way to enhance patient-oriented care. Am J Med. 1999;107:425-431, (C) 1999 by Excerpta Medica, Inc.