Patient Satisfaction in Rural Versus Non-Rural US Hospitals

Assessing patient satisfaction is an effective way to provide an evaluation of the quality of healthcare services. As a result, the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Patient Survey was established as the first standardized national survey to publicly report patient ratings on hospital care. There remains a lack of research that examines rural-urban distinctions in patient satisfaction. The objective of this study was to investigate if there is a difference in hospital determinants of patient satisfaction among hospitals based on rural status.

The study utilized two public datasets containing HCAHPS survey results from 4714 US hospitals and from eligible cancer hospitals that participate in the Prospective Payment System-Exempt Cancer Hospital Quality Reporting. The data were collected from July 1, 2021 to June 30, 2022 and published by Centers for Medicare & Medicaid Services. Rural status of each hospital was determined by matching zip codes with data provided by the Health Resources & Services Administration.

A total of 3248 hospitals were included in the analysis, with approximately 51.14% located in rural areas. There was a significant difference across every hospital determinant when comparing rural and non-rural status. Rural hospitals had a higher score for every hospital determinant (Cleanliness, Nurse communication, Doctor communication, Staff responsiveness, Communication about medicines, Discharge information, Care transition, Overall hospital rating, Quietness, and Willingness to recommend the hospital), indicating better performance.

Rural hospitals demonstrated better HCAHPS performance across every hospital determinant in comparison to urban hospitals, suggesting possible recent improvements. Future research is necessary to investigate this trend and its consistency, which can inform targeted interventions to better address the healthcare needs of diverse populations in the United States.