WASHINGTON -- Many hospital patients are dissatisfied with some aspects of their care and might not recommend their hospitals to friends and relatives, the federal government said yesterday as it issued ratings for most of the nation's hospitals, based on the first uniform national survey of patients.
The survey was meant to provide a constructive way for patients to complain about arrogant doctors, crabby nurses and dirty or noisy hospital rooms. Medical experts said some of the complaints bore directly on the quality of care.
Many patients reported that they had not been treated with courtesy and respect by doctors and nurses, that they had not received adequate pain medication after surgery, and that they did not understand the instructions they received when discharged from the hospital.
Nationwide, in the average hospital, 67 percent of patients said they would definitely recommend the institution where they were treated to friends and relatives. But 63 percent gave their hospitals an overall score of 9 or 10 on a scale of 0 to 10.
At the average hospital, more than 25 percent of patients said nurses had not always communicated well with them.
The new data, part of a survey of patient experiences and perceptions of hospital care, is posted at a government Web site: www.hospitalcompare.hhs.gov. The site has survey information from many Baltimore-area hospitals, including the Johns Hopkins Hospital, University of Maryland Medical Center, GBMC and Mercy Medical Center.
Richard J. Umbdenstock, president of the American Hospital Association, which helped develop the measures, said they allowed "an apples-to-apples comparison" of hospitals at the state, local and national levels.
But the results provide cause for concern, said Carolyn M. Clancy, director of the Agency for Healthcare Research and Quality, a unit of the Public Health Service.
"Poor communication is a major source of medical errors," Clancy said. "If doctors are not listening carefully, patients may not bring up important information. Patients who do not understand discharge instructions are more likely to be readmitted to the hospital or end up in the emergency room."
Nancy E. Foster, a vice president of the American Hospital Association, agreed that many hospitals need to do a better job of controlling pain and communicating with patients.
Pain control keeps patients comfortable and can speed healing and reduce complications after surgery.
Many large teaching hospitals scored below the national average on questions about the cleanliness and quietness of the hospital environment. Patients were asked: "How often were your room and bathroom kept clean? How often was the area around your room quiet at night?"
Consumer groups, employers and labor unions hailed release of the data, saying it would make hospitals more accountable.
Doug Salvador, the patient safety officer at Maine Medical Center in Portland, said: "Forty years ago hospitals were looked at as trusted friends. But there has been a relative decline in positive feeling about hospitals, because of all the attention to medical errors, the fear of hospital-acquired infections and the commercialization of medicine."
The Department of Health and Human Services has previously published hospital mortality rates and clinical measures of performance, indicating whether hospitals appropriately treated heart attacks, pneumonia and other conditions. Yesterday, the government provided comprehensive data on consumer satisfaction for the first time.
States showed substantial variation on that particular measure. The average for all hospitals reporting data was 79 percent in Alabama, compared with 76 percent in Utah, 74 percent in Maine and New Hampshire, 69 percent in Connecticut, 64 percent in New Jersey, 62 percent in New York, 61 percent in Florida, 60 percent in New Mexico and 56 percent in Hawaii.
Nationwide, at the average hospital, 63 percent of patients gave the hospital an overall rating of 9 or 10. Alabama ranked high, with an average score of 73 percent, and Hawaii was relatively low, with an average of 52 percent. The average was 57 percent for New York, 59 percent for New Jersey and 62 percent for Connecticut.
The data came from questionnaires completed by a random sample of patients treated at more than 2,500 hospitals from October 2006 to June 2007. Some hospitals chose not to cooperate, but they will soon have a financial incentive to do so.
Herb B. Kuhn, a Medicare official, said if hospitals did not report the data, their Medicare payments could be reduced, by about $100 for a typical case.