International Journal for Quality in Health Care Advance Access originally published online on September 14, 2007
International Journal for Quality in Health Care 2007 19(6):382-389; doi:10.1093/intqhc/mzm041
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Evidence of a non-linear influence of patient age on satisfaction with hospital care
1 Public Health Department, University Hospital of Nantes - France
2 Inserm, U669, Paris, F-75014 France ; Univ Paris-sud 11, Le Kremlin Bicêtre, F-94000 France ; Univ Paris 5, Paris, F-75015 France ; APHP, Villejuif, F-94804 France
3 Direction de la Politique Médicale, APHP, Paris, France
Background. Patient age is the main socio-demographic factor influencing patient satisfaction with care but the nature of the relationship between age and patient satisfaction is controversial.
Objective. This study aims to clarify whether the association of age with satisfaction is linear or shows some other configuration.
Methods. Data were obtained from two different satisfaction studies conducted in 27 short-stay teaching hospitals. Study 1 included 1547 inpatients, who completed the EQS-H questionnaire at the time of discharge. Study 2 included 7624 inpatients interviewed by phone at home after discharge, who answered the SAPHORA questionnaire. On the basis of the results of the exploratory analysis, three models for adjustment of age on satisfaction were compared: a simple linear model, a five-group step function and a linear model with a change in slope.
Results. The most suitable model for adjusting patient age to satisfaction scores for quality of medical and nursing care, whether for the EQS-H or the SAPHORA scale, was not a linear relationship: patient age was linearly and positively correlated to satisfaction before 65 years and negatively thereafter. Adjustment of patient age to accommodation and premises satisfaction scores proved to be different, closer to a linear relationship.
Conclusion. These results suggest considering the patient age variable as a non-linear factor for adjusting satisfaction scores, in particular in relation to care. Further studies are needed to confirm the evidence of a threshold around 65 years beyond which satisfaction scores for the quality of medical and nursing care decrease.
Keywords: adjustment, inpatient satisfaction, patient age, questionnaire, quality of care
Address reprint requests to: Leila Moret; Dr. Leïla Moret Unité Qualité-Risques-Evaluation Public Health Department - PIMESP, Hôpital Saint-Jacques, 44093 Nantes CEDEX, Tel: +33 2 40 84 69 24; Fax: +33 2 40 84 69 21; E-mail: lmoret{at}chu-nantes.fr
Accepted for publication August 8, 2007.