Patient perceptions of healthcare quality and the role of provider quality reporting metrics: Evidence from the survey of the health of Wisconsin

We sought to look at the association between system level quality reporting and patient perceived quality of care for the Wisconsin population. Data are from the 2008-2011 Survey of the Health of Wisconsin (SHOW) and Wisconsin Collaborative for Healthcare Quality (WCHQ). Our sample includes 2,183 adults who were matched to their usual provider. WCHQ provider performance on standard quality reporting metrics were used to determine WCHQ provider rankings. Provider type and rankings were used to predict patient report of quality of care and satisfaction with care, both for the last encounter and overall, adjusting for patient gender, age, educational attainment, health insurance status, chronic condition status, and receipt of services. Individuals who received more services rated the quality of care at their last encounter more favorably than did individuals who received fewer services, irrespective of whether or not those services were necessary. Those with worse performing providers were more likely to feel neutral about their last encounter. Individuals with no usual provider were more likely to rate their last encounter poorly but less likely to say that they were dissatisfied with their care overall. Provider ranking were not associated with ratings of care overall. Patient age, education, and insurance were the strongest predictors of overall ratings of care. Patients demonstrate a higher satisfaction with care when they receive a greater number of services, even if those services are not medically necessary, suggesting that patient satisfaction disincentivizes efficient care.