Background: Centers for Medicare & Medicaid Services (CMS) recommends against the use of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) for determining patient satisfaction with physicians, however, hospital administrators often use HCAHPS scores as one metric for determining physician incentives. Such use of HCAHPS likely results from its easy availability and lack of simple, easy, and quick to use ‘patient satisfaction with physician communication’ tools. Tool to Assess Inpatient Satisfaction with Care from Hospitalists (TAISCH), the only published such tool is relatively long and may be difficult to complete for patients with low literacy levels. Therefore, we developed and validated a simple 5-question satisfaction (5QS) questionnaire to examine patient satisfaction with physicians and compared it with the TAISCH.
Methods: Hospitalized patients older than 18 years and who provided consent were asked to complete a questionnaire which collected information on patient’s age, gender, and race and included 5 questions assessing patient satisfaction (overall quality of the physician, communication skills, involvement of patient in decision making, explanation of test results, and overall teamwork between team members) on a 5-point Likert scale (5QS). A subset of patients also completed TAISCH for comparison. Mean (SD) and percentages were used to summarized data. We used exploratory factor analysis to determine factor loading and confirmatory factor analysis (CFA) using structural modeling for validation of the questionnaire. All analyses were performed using Stata 14.0.
Results: Of the 1723 patients who completed 5QS, 612 also completed the TAISCH. The study population consisted of 54% females, 84% Caucasians and had a mean age of 53.6 (17.3) years, mean 5QS score of 4.2(0.8), and mean TAISCH score of 3.8(0.7). The Cronbach alpha for the 5QS was 0.93 and for TAISCH was 0.90. In exploratory factor analysis, all questions from the 5QS loaded on a single factor highlighting strong construct and face validity. The CFA found adequate convergent and discriminant validity and showed strong fit of the model to the data using routine diagnostic statistics (Figure). In contrast, CFA found poor fit of the TAISCH to the data (Figure).
Conclusions: We present evidence for the reliability and validity of a new instrument, 5QS, to assess satisfaction of hospitalized patients with their physicians. This instrument is simple, easy, can be completed in a short period, and may have better characteristics than the published tool.
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