In a study published this year in the journal Health Services Research, researchers analyzed the results of a survey that asked nearly two million patients how they felt about their hospitalization. Known as the Hospital Consumer Assessment of Healthcare Providers and Systems, or Hcahps (pronounced “H-caps”), and administered to patients within six weeks of discharge, the survey consists of 27 questions about topics ranging from communication with nurses and doctors and responsiveness of hospital staff to general cleanliness and noise levels.
When the researchers divided the questionnaire results by the patients’ sex, they discovered that men tended to be more positive over all about their hospital experiences. Women were less satisfied with staff responsiveness, their discussions with nurses, communication about medications and discharge plans and the general conditions of the hospital. Among men and women who were older or felt sicker, these differences were even more pronounced.
“What patients require when they are ill and feeling vulnerable is not the same,” said Marc N. Elliott, the study’s lead author and a senior statistician at the RAND Corporation in Santa Monica, Calif. “What’s becoming clear is that we are not meeting the needs of female patients.”
In some cases the extent to which male and female patients differed in their satisfaction levels was substantial, surprising even the researchers. “There was a fairly consistent gender gap,” Dr. Elliott said. “But some of the differences were on the same magnitude as what you might see among patients from different ethnic groups or widely disparate socioeconomic backgrounds.”
One of the more marked differences was the amount of information about medications or discharge plans that patients needed to feel sufficiently informed. Women generally wanted more information than they received, while men were satisfied with what they were told. There were also considerable disparities between men and women regarding cleanliness, with women inclined to be less satisfied with the hygiene of hospital surroundings.
The findings from this study underscore how complex addressing quality and patient experience can be. Currently, most health care improvement efforts tend to treat patients as a monolithic group. It’s an oversight that can be attributed, at least in part, to the relative paucity of research and data on the patient experience.