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A study published in today's New England Journal of Medicine finds that most U.S. hospital patients are generally satisfied with their care and suggests that higher nurse-to-patient ratios are associated with moderately better hospital performance on interpersonal aspects of patient care, USA Today reports. To assess hospital performance across multiple aspects of the patient experience, researchers from the Harvard School of Public Health and colleagues reviewed data from the Hospital Consumer Assessment of Healthcare Providers and Systems survey, as well as clinical care measures from the Hospital Quality Alliance (HQA) program. Of the 4,032 hospitals that report care quality data to HQA, 2,429, or 60.2 percent of the nation's hospitals, reported data on patients' experiences. The researchers found that, on average, 67 percent of a hospital's patients said they would definitely recommend the facility to others. According to the study authors, patient ratings tended to be more positive at hospitals with the highest ratio of nurses to patient-days. Specifically, hospitals in the highest quartile for this nurse staffing ratio garnered higher marks from patients on nursing services, discharge instructions, communication with nurses and communication about medications than hospitals in the lowest quartile for the ratio of nurses to patient-days. Noting that it was unclear whether these relationships "were causal or a marker of the hospitals' commitment to better service," the researchers suggest that "the same characteristics of hospitals that lead to high nurse-staffing levels may be associated with better experiences for patients." Meanwhile, patient satisfaction with care also appeared to be associated with care quality performance, as patients reported more satisfying care experiences at hospitals that had higher levels of care quality as defined by their performance on HQA clinical metrics. Shedding light on opportunities for improvement, the study reveals that nearly one-third of patients did not give high marks for pain control, and about one-fifth of patients expressed dissatisfaction with the discharge process, reporting that they were not given clear instructions. Noting that public disclosure of data on clinical performance has prompted improvements in clinical care quality in hospitals, the researchers say they hope that "regular reporting on performance on patient-reported measures of quality will catalyze similar improvements in patient-centered care" (Rubin, USA Today, 10/30/08; Jha et al., New England Journal of Medicine, 10/30/08 [subscription required]; Reinberg, HealthDay, 10/29/08; Groch, MedPage Today, 10/29/08).