The results of the 2010 patient satisfaction survey - performed by an independent survey company (not sure which one) - was published recently. Overall satisfaction with the public health sector remained high compared to previous years, although the larger hospitals (SGH, TTSH and NUH) play musical chairs for the bottom spot (SGH is "it" for 2010) regularly. The detailed scores for the service quality attributes (i.e. care coordination, skills of health professionals, care and concern shown, etc) are not published, but presumably dedicated teams at each hospital pore over these results in search of areas of improvement each year.
It is unclear what the results really mean, especially when the "flower hospital" (you have to click on the KTPH button on the banner at the top here) comes up tops. Well done, of course, when the former AH team duplicate their award-winning patient-pleasing ways in the new hospital. These surveys have gone on for a number of years, and a neutral and careful review of the pros and cons of such surveys in general can be found here (only the abstract). It is important to note that patients who are healthier tend to report higher satisfaction as opposed to those with improvements in health - a consideration for why tertiary hospitals tend to fare worse when placed in the same bracket as smaller secondary hospitals.
The other kind of surveys published by MOH are costs of procedures/hospitalizations for a fixed number of common clinical conditions. These may be useful for indirectly keeping costs down (or at least relative to the public sector standard) for the most part.
But surely it is time that we find out a bit more about technical quality? The data should be readily available for such reports by now. The US has had hospital rankings for ages. If I have breast cancer (touch wood), which center will provide me better and longer quality of life (hopefully without exotic and expensive chemotherapy)? If I need a knee implant, what are the infection rates at various hospitals? If I have leukemia (touch wood twice!), should I just go overseas for treatment? How likely am I to get unnecessary tests and treatment if I visit a public as opposed to private hospital (alright, data for this last question never gets collected or compared)? For a country that has one of the best reputations for healthcare in the region, such data are hard to find. But they can help drive competition in another important direction, i.e. by focusing on patient-centric clinical outcomes
7 comments:
I think we need to always carry the medicine cabinet, but a duty is a duty, something that never happens until it happens and not bad to have this hand:
Thank you for posting this. FYI, the day the article was published, I mentioned it to the lady who runs a vegetables stall near my home. Her mother has cancer and was recently warded at KTPH.
Her reaction when told KTPH topped the patient satisfaction survey: (I quote) Hah? *grimace*
My dad, who sees an endocrinologist at KTPH, waited 4 hours to see his doctor in the clinic not too long ago. Almost suffered a hypoglycemic episode in the process.
So why weren't these 2 patients surveyed? Selection bias? Tsk tsk...
Anyway, SGH shouldn't bother too much with the dubious results. I frequently encounter patients who AOR from other hospitals to SGH for 2nd opinions. There will be no shortage of business. :)
But it matters to the KPI for the KTPH admin staff.
I am sure the KPI for different hospitals differ accordingly which is why SGH doesn't bother too much about this survey.
For KTPH if they don't do well in this survey then habis liao
Be careful what you wish for, it may just come true... :-p
This survey must be flawed if it chose to avoid the key issues, like waiting time, that they knew will give them a thumbs right down. Or could it be like those random surveys I encountered before (bank) where they attend to you exceptionally good, like a VIP, among other customers waiting, and then courteously asked if you mind to fill-up a survey form for them. I'm sure they got to ensure the results are believable, by getting 1, out of many, from an unhappy face. I too am very surprised that KTPH can be top; thought its my luck that I always went on a bad day.
Sure. Anything that does not conform to your impression of how the world is MUST be a lie...
What in the world is "patient satisfaction"?
In most countries they look at objective parameters like waiting times for specialist appointments. Waiting times for operations.
Survival rates. Complication rates.
I mean I doubt NEJM or Lancet is going to publish any paper where the measured outcome is "patient satisfaction score".
Imagine trying to study whether treatment A is better than treatment B and your basis for saying so is that patients who took A gave higher "patient satisfaction" scores than the group that took B.
Rubbish. Utter rubbish. It is just propaganda to make patients feel like what they want and think should be the most important determinant for doctors to base their medical decisions on.
Same with "patient centric".
All these are based on the customer first model that commercial service industries and commercial retailers use.
Healthcare is not like that.
A good example is to look at the legal system. You hardly ever see "client satisfaction" scores when it comes to rating Supreme Court, Subordinate Courts,Family Courts.
Can you imagine asking a person who has been sentenced to hang for drug trafficking how "satisfied" he was with the legal system?
Please lah. Doctors are professionals. Not salesmen and service providers.
In fact I would say it is quite easy to just focus on making patients feel very happy and satisfied saying and doing what they want all the time. But if all doctors were to do that, you will start to realize how crappy the healthcare system truly is when you measure clinical outcomes.
Anyway this is probably the direction from KBW.
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