Editor’s note: The following is an excerpt from “The Patient Experience and Health Outcomes,” published in The New England Journal of Medicine.
Do patients’ reports of their health care experiences reflect the quality of care? Despite the increasing role of such measures in research and policy, there’s no consensus regarding their legitimacy in quality assessment. Indeed, as physician and hospital compensation becomes increasingly tied to patient feedback, health care providers and academics are raising strong objections to the use of patient-experience surveys. These views are fueled by studies indicating that patient-experience measures at best have no relation to the quality of delivered care and at worst are associated with poorer patient outcomes. Conversely, other studies have found that better patient experiences — even more than adherence to clinical guidelines — are associated with better outcomes. Which conclusion is correct? We believe that when designed and administered appropriately, patient-experience surveys provide robust measures of quality, and our efforts to assess patient experiences should be redoubled.