Hearing the patient’s voice: The patient’s perspective as outcome measure in monitoring the quality of hospital care

Sorien Kleefstra

Research output: ThesisThesis: Research University of Amsterdam, graduation University of Amsterdam


The overall theme of this thesis is to contribute to the knowledge of how to use the patient’s perspective for monitoring the quality of hospital care. The patient’s perspective is measured with patient satisfaction questionnaires and with a patient rating website. Our studies showed that valid and reliable patient satisfaction questionnaires can indeed be used to assess or monitor the quality and safety of care from the patient’s perspective. This is in spite of the critical comments concerning the concept and the methodological considerations when addressing patient satisfaction. When used for improvements in the quality of care, reliable comparisons of patient satisfaction scores between, and within, hospitals and over time, can be made. However, they should be corrected for case mix with regards to patient characteristics, such as age, education and health status. They should also contain qualitative comments and be tailored either to a lower level than the hospital, such as department or specialty, or to specific subgroups such as unsatisfied patients. A direct correlation between patient satisfaction scores and an organizational indicator such as the length of stay could not be found. Finally, the patient’s perspective as presented by reviews on patient rating sites, as a new development, can contribute to the detection of risks to patient safety. These patient rating sites offer new opportunities for hospitals and health care inspectorates to use the patient’s perspective in improving and monitoring the quality and safety of hospital care.
Original languageEnglish
Awarding Institution
  • University of Amsterdam
  • de Haes, Hanneke J. C. J. M., Supervisor
  • Kool, R. B., Co-supervisor, External person
  • Zandbelt, L. C., Co-supervisor
Award date6 Jul 2016
Print ISBNs9789462993600
Publication statusPublished - 2016

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