Patient assessments of hospital maternity care: Variables which contribute most to increase satisfaction

Background: This study examined the assessments of care by women who were hospitalized for labour and delivery in 22 hospitals in Dresden, Germany. Patient assessments in this group of patients are of particular interest because labour and delivery is not an unexpected event. Women have the opportunity to select the preferred hospital prior to admission. Decisions might be influenced by prior experiences and recommendations by others. Understanding which variables contribute to increase satisfaction is important since in industrialized countries objective outcome parameters such as mortality rates are uniformly low which does not provide a reliable basis to compare the quality across hospitals. Therefore, subjective perceptions of patients might represent a proxy outcome indicator. Methods: The study sample included 1433 inpatients aged 15 years and older discharged in 2010. Patient assessments and socio-demographic characteristics were measured using a validated questionnaire. Logistic regression analysis was used to identify determinants of overall satisfaction (p<0.05). Results: Determinants were variables reflecting the interaction between physicians, nurses and patients as well as organization of procedures (OR: 1.64) and discharge (OR: 1.54). Interpersonal manner of nurses was a stronger determinant of satisfaction (OR: 2.91) than communication between patients and physicians (OR: 1.44). Variables reflecting information receiving such as the quality of instructions were not associated with satisfaction. Conclusions: This research suggests that organizational and interpersonal aspects of care - particularly the interaction between nurses and patients - are strong drivers of satisfaction and are more important to patients in obstetrics than service and technical aspects of care.