Adjustment for patient characteristics in satisfaction surveys

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Abstract
The ideal quality indicator measures a specific aspect of the quality of health care and nothing else. Unfortunately, this is often not the case, particularly for outcome indicators, which often reflect a variety of patient characteristics that are not under the provider’s control. Take patient satisfaction surveys: we all know of grumpy patients who complain even when they receive the best care, and of patients who are thankful and uncomplaining even in the worst conditions. Comparisons of mean satisfaction scores between health care providers who do not serve the same profile of patient population may be biased. Unadjusted results of satisfaction surveys are often mistrusted by providers, particularly those who fare poorly in comparison with others, and are therefore not used to improve care.

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