The management of patient complaints and dissatisfaction.

Patient satisfaction is an integral component of the measurement of health care quality. Proper attention to patient complaints is one part of a patient satisfaction management strategy aimed at revealing and alleviating the causes of patient dissatisfaction.

Emergency department complaint frequency: variation by patient median household income.

STUDY OBJECTIVE: To determine whether emergency department complaint frequency varies with patient median household income, as approximated by patient residence zip code. DESIGN: All patient visits and complaints received in one ED were reviewed. Median household income of patient residence zip codes was obtained from available demographic data. Patients were categorized into seven income categories. EXCLUSIONS: Cases in which zip codes could not be determined or zip code income data could not be obtained; complaints from physicians, not patients; and data from zip codes remote from the hospital. SETTING: Nine hundred twenty-nine-bed teaching hospital. TYPE OF PARTICIPANTS: All ED visits and all ED complaints over a four-year period. STATISTICAL ANALYSIS: Armitage's chi 2 test for trend of proportions was used to compare complaint frequencies in different income groups. RESULTS: A total of 277,210 patient visits and 675 complaints met study criteria. Complaint frequencies ranged from 1.65 to 3.14 per thousand visits. Higher-income patients were more likely to complain than lower-income patients (P = .0000058). CONCLUSION: In this setting, ED patients residing in higher median income zip codes are more likely to register complaints than those from lower-income zip codes. Complaint frequencies from hospitals with different demographics may not be comparable.

Emergency department complaints: a one-year analysis.

We conducted an analysis of all complaints received in a busy suburban emergency department during 1985. All complaints were handled in a standardized fashion, and were categorized as billing, physician, nursing, or miscellaneous. Data were expressed as a "complaint frequency" (complaints per 1,000 patient visits). Complaints were analyzed for the following characteristics: reason, gender of the patient, gender of the complaining party, relationship of the complaining party to the patient, health care provider, patient age, and patient disposition. The chi-square method was used to identify characteristics associated with a high risk for complaints. There were a total of 244 complaints, arising from 64,910 patient visits, yielding an overall complaint frequency of 3.8. The largest number of complaints (135), involved billing (frequency, 2.0). The most common (60) was insurance carrier rejection of the bill as a nonemergency. The next most common billing complaint (25) was a charge mistakenly billed too high by the ED. There were 70 complaints regarding emergency physicians, for a complaint frequency of 1.1. Of these, 17 were due to a perceived lack of communication with the patient, the patient's family, or the patient's private physician. Eighteen complaints were regarding a perceived misdiagnosis. One physician had a significantly higher complaint frequency than the group as a whole (P less than .005). There were 17 complaints regarding the nursing staff, for a complaint frequency of 0.2. Twenty-two complaints were classified as miscellaneous. Expressing data as complaint frequencies allows comparison of trends in a department, staff members, and different EDs with varied patient populations.(ABSTRACT TRUNCATED AT 250 WORDS)