International Journal for Quality in Health Care Advance Access originally published online on September 17, 2008
International Journal for Quality in Health Care 2008 20(6):412-420; doi:10.1093/intqhc/mzn041
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Content analysis of patient complaints
1 Department of Cardiology and Comprehensive Care, New York University College of Dentistry, New York, NY, USA
2 American Society of Law, Medicine and Ethics, Boston, MA, USA
3 Department of Critical Care Medicine, Foothills Medical Centre, University of Calgary, Calgary, AB, Canada
Objective. To develop a standard taxonomy for inpatient complaints that could be adopted in a wide array of health service institutions.
Design. A taxonomy was developed by merging the coding schemes from eight prior studies of patient complaints, and then by revising the received coding scheme in light of the codes and clarifications that emerged from a content analysis of patient complaints.
Setting. Two Boston area hospitals.
Participants. Stratified random sample of 1216 complaints from patients in 2004.
Intervention(s). None.
Main outcome measure(s). Patient complaints codes, provider codes and inter-rater reliability.
Results. A taxonomy comprising 22 patient complaint codes and five provider codes was developed. Inter-rater agreement for complaint codes was good (median Kappa statistic 0.66, interquartile range 0.55–0.80). Four codes were each used in more than 10% of the patient complaints filed: unprofessional conduct (19%); poor provider–patient communication (17%); treatment and care of patient (16%); and, having to wait for care (11%). Of the coding for the profession of the person complained about, 47% of the patient complaints were about staff in general or did not specify a particular profession; 22% identified a physician or dentist; 12% nursing staff; 11% administrative or support staff and 8% allied clinical health professionals.
Conclusions. Standardized coding of patient complaint data may provide an opportunity for quality improvement, patient satisfaction and changes in patient care.
Keywords: patient complaint, patient satisfaction, quality of healthcare, malpractice, medical errors, quality assurance, healthcare
Address reprint requests to: Henry Thomas Stelfox, Department of Critical Care Medicine, Foothills Medical Centre, University of Calgary, 1403-29th St. NW, EG-23A, Calgary, AB, Canada T2N 2T9; E-mail: tom.stelfox{at}calgaryhealthregion.ca
Accepted for publication August 14, 2008.
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