Factors Impacting Patients' Willingness to Recommend: A Structural Equation Modeling Approach.

Area of Science:

• Health Services Research
• Patient Experience
• Healthcare Quality Improvement

Background:

• Patient satisfaction is linked to financial benefits and improved health outcomes for hospitals.
• Limited research simultaneously examines within- and between-hospital factors influencing patient recommendations.
• Understanding these predictors is crucial for enhancing hospital performance and patient care.

Purpose of the Study:

• To identify predictors of patients' willingness to recommend a hospital.
• To analyze these predictors at both within-hospital and between-hospital levels.
• To inform strategies for improving patient satisfaction and hospital reputation.

Main Methods:

• Multilevel structural equation modeling was employed.
• Data from 12,115 patients across 60 U.S. general medical and surgical hospitals were analyzed.
• Simultaneous examination of within- and between-hospital effects was conducted.

Main Results:

• Within hospitals, patient ratings of overall quality of care strongly predict willingness to recommend.
• Patient perceptions of the hospital environment and nursing care significantly influence overall quality ratings.
• Overall patient satisfaction is a key predictor at the between-hospital level; hospital size and location had minor effects.

Conclusions:

• Patient ratings of care quality, environment, and nursing are critical for driving recommendations within hospitals.
• Overall patient satisfaction is a significant factor influencing hospital choice at a broader level.
• Targeting improvements in care quality and patient experience can enhance hospital reputation and patient loyalty.