Quality of Care Assessment in Pediatrics: Are Parents the More Challenging Patients?

The study aims to analyze the impact of proxy responses of parents of pediatric patients on quality of care assessments. Data used in this study were obtained from 5,551 randomly selected patients from three medical departments who responded to a mailed survey. The instrument consisted of 37 items and assessed medical and service aspects of the hospitalization, patient demographic data, as well as visit characteristics. Regarding pediatrics, parents acted as a proxy response for their children and filled in the survey. Potential differences in patient assessments were determined by comparing satisfaction ratings of parents and the remaining patients using non-parametric tests. The majority of patients were satisfied with the hospitalization; however, parents of pediatric patients were significantly less satisfied than patients of internal medicine and surgery and were also less likely to choose the same facility in case of another hospitalization. Most of the items measuring medical and service aspects of the hospital stay received significantly lower ratings by parents in comparison to participants of internal medicine and surgery. The perception of length of stay affects satisfaction ratings of patients of all medical departments. Patients who judged the hospital stay as appropriate were significantly more satisfied and more often willing to choose the same facility in case of another hospitalization than patients who perceived the hospital stay as too short or too long. In direct comparison to internal medicine and surgery, the parents of pediatric patients assessed the duration of the hospitalization three times more often as too long. Study findings show that parents acting as a proxy for their children report lower satisfaction ratings in comparison to self-reports of other patient cohorts, and also that the subjective perception of the length of stay influences satisfaction ratings.