Patients overall in the United States are very satisfied with their physicians and with treatment they receive in outpatient settings, according to new information which challenges common public perceptions about outpatient medical treatment.

"Particularly surprising is that even a lot of patients who reported average encounters with physicians, such as average national wait times and average physician encounter time, seem to be giving full marks to their physician in terms of visit satisfaction," said Rajesh Balkrishnan, lead study author and associate professor in the University of Michigan School of Public Health and College of Pharmacy.

The study analyzed data from an online survey tool*, where 14,984 patients ranked visits from 2004-2010 on a 10-point scale, with 10 being the highest. The study included only physicians with 10 or more ratings, and patients could rate a particular doctor only once every three months, to prevent skewed scores.

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Patients without insurance have significantly shorter hospital stays than patients with insurance, raising concerns that hospitals may have incentive to release these patients earlier to reduce their own costs of uncompensated care, according to a study.

Researchers analyzed nationally representative data on a weighted sample of more than 90 million hospitalizations between 2003 and 2007 of patients ages 18 to 64. They found that across all hospital types (for-profit, nonprofit and government), the average length of stay for preventable hospitalizations — those thought to be avoidable with the use of appropriate preventive care and disease management — was significantly shorter for individuals without insurance (2.77 days) than for those with either private insurance (2.89 days) or Medicaid (3.19 days).

For patients hospitalized for other diagnoses, the average length of stay was also shorter for uninsured patients (2.74 days) than for those with private insurance (2.86) or Medicaid (3.13).

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By Bill Santamour November 08, 2011

Nurses closely monitor medication use, reduce readmissions.

Marcy left the hospital with a lot of paper work, a container of pills and an appointment to see her physician the following month. The instructions were thorough and the discharge staff were patient and pleasant. But Marcy was still a little weak from the infection that had landed her in the hospital in the first place, and flustered by the whole experience. And, she had to admit, these days she got confused more easily than she had in the previous 83 years of her life; neither her memory nor her sight were what they used to be.

A few days later, Marcy mistakenly thought she had forgotten to take her morning medication and swallowed a day's worth all at once. The overdose nearly killed her, and she landed back in the hospital.

Her experience is not unusual, but with the renewed emphasis on improving quality of care and reducing readmissions, it has to become a lot more rare.

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