Does depression correlate with elderly patient satisfaction and perceived quality of hospital care?
- V Raftopoulos1
© The Author(s) 2003
Received: 1 November 2003
Published: 23 December 2003
Patient satisfaction with quality of hospital care is a dominant concept with respect to the implementation of quality assurance and quality improvement programs. Elderly patients are the central users of health care services and therefore the assessment of elderly perceived quality of hospital care is important for strategy planning and evaluation of health care services. The relevance of patient satisfaction studies is often questioned because of conceptual and methodological problems due to the underused qualitative research. The aim of this research was to develop global scales that, in comparison with existing patient satisfaction scales would: (1) be valid and reliable, assessing elderly patients' satisfaction with quality of hospital care, based on the existing literature evidence, on results of a qualitative research and on a previous developed conceptual framework, (2) measure perceived quality of hospital care from the perspective of elderly patients and (3) explore how elderly patients' depression (by using Geriatric Depression Scale) correlates with patient satisfaction and perceived quality of hospital care.
Material and Methods
380 elderly patients from 8 Greek hospitals participated to the study (209 male, 171 female). The mean age of the sample was 73.07 ± 6.04 years. We evaluated the taxonomy and the feasibility of the scales using reliability analyses. We used a combination of qualitative and quantitative research methods.
The vast majority of elderly patients were somewhat satisfied with quality of hospital care (90.3%), of food (79.3%), of medical (95.6%) and nursing care (94%). Regarding the hospital services, elderly patients expressed also dissatisfaction with hospital care (0.8%), food (9.6%), medical (0.5%) and nursing care (2.9%). Among the depressed elderly patients, a high percentage (82.8%) was satisfied with global hospital care, with food (73.3%), medical (93.1%) and nursing care (93.2%). Dissatisfaction was expressed with global quality of hospital care (0.7%), of food (1.4%), medical (1.4%) and nursing care (0.1%). Elderly patients' depression correlates negatively with (a) perceived quality of hospital care, of medical and nursing care, (b) global satisfaction with care and hospital food, and (c) their expectations from hospital care.
For the depressed elderly patients their level of global satisfaction with hospital care, food, medical and nursing care was greater than their expectations. With increasing age, elderly patients express greater mean global satisfaction with hospital and nursing care. Elderly patient depression affects perceived quality of hospital care and satisfaction. Global satisfaction with provided nursing care is the main predictor of global satisfaction with hospital care, between the non-depressed elderly patients. On the contrary, in the sample of the depressed elderly patients, the main predictor is the global satisfaction with medical care. Global perceived quality of hospital care predicts more, global satisfaction with hospital care.