Patient satisfaction in German hospitals. EHMA Annual Conference, Innsbruck, June 26, 2009 Markus Jochem, Dr. Susanne Klein, Hamburg

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1 Patient satisfaction in German hospitals Results of biggest survey on hospital quality EHMA Annual Conference, Innsbruck, June 26, 2009 Markus Jochem, Dr. Susanne Klein, Hamburg

2 Techniker Krankenkasse (TK) is Germany's biggest sickness fund insures 7.2 million people budget of 17 bn EUR in

3 Topics What are the goals of the survey? How is it done? What are the results? What have we learned? What s next? 3

4 Quality Transparency in Germany Since 2005, German hospitals are obligated to publish bi-annual reports on structure and (partly) process quality, enhanced in 2007 by data on the outcome quality in a few diagnosis and operations. TK was first in line to publish these reports in an Internet-based search engine (TK-Klinikführer). TK aims at putting more information to its clients by evaluating patients experience in the clinics to give them a better foundation for their decision, which hospital to choose. And: Gathering valuable and reliable information for discussions and negotiations with hospitals on quality and quality development 4

TK was first in line to publish these reports in an Internet-based search engine (TK-Klinikführer).

5 5 Presenting the results

6 6 Presenting the results

7 Presenting the results About 20,000 patients use the search engine each month 7

8 Developing a nationwide survey (I) Four-page questionnaire, comprising of 42 questions regarding the identity of the patient, the hospital and its department, the medical treatment and its success, patients satisfaction with information, communication, services, recommendation to others (relatives, acquaintances, patients). 8

the medical treatment and its success, patients satisfaction with information,

9 Developing a nationwide survey (II) Survey started in 2006 and 2007 with around 200 hospitals, i.e. 10 per cent of all clinics in Germany. In 2008, the survey was spread to cover all hospitals, in which at least 250 TK-insured patients were treated. As a result, about 650 hospitals were involved. Of course, the survey was conducted completely anonymous and according to academic standards. 9

were treated. As a result, about 650 hospitals were involved.

10 Developing a nationwide survey (III) 265,000 TK-clients, who had a hospital stay of three days or more in 2008, received the questionnaire about four weeks after being released from the clinic. There were no reminders. The response quota was 59,9 per cent and we witnessed hardly any missing values. 10

weeks after being released from the clinic. There were no reminders.

11 And the winner is... All questionnaires are evaluated with a points system. There is no overall result per hospital (and no ranking either), but there are five individual scores per clinic: general satisfaction and satisfaction with the treatment result, care and support, information and communication, organisation and housing. 11

five individual scores per clinic: general satisfaction and satisfaction with the

12 What are the results of the 2008 survey (I)? The gap between highest and lowest result has widened between 2007 and high/low Difference high/low Spread Development General 92,7 64,4 28,3 93,7 62,2 + 3,2 satisfaction Treatment result Care and support Information, communication Organisation and housing 87,7 65,4 22,3 87,7 66,6-1,2 88,8 66,5 22,3 89,5 65,9 + 1,4 89,5 69,3 20,2 91,1 68,0 + 2,9 87,6 57,9 29,7 89,0 57,7 + 1,6

2008 high/low Spread Development General 92,7 64,4 28,3 93,7 62,2 + 3,2 satisfaction Treatment result Care and

13 What are the results of the 2008 survey (II)? Hospitals with high results in 2007 tend to stay ahead in 2008: based on the 300 hospitals of the 2007 survey Staying in the Staying in the TOP 10 Bottom 10 General 6 8 satisfaction Treatment result 4 4 Care and support Information, communication Organisation and housing

hospitals of the 2007 survey Staying in the Staying in the TOP 10 Bottom 10

14 What are the results of the 2008 survey (III)? 200 hospitals are above average in every of the five individual scores. Another 77 clinics exceed the average in four of the five scores 27 hospitals collect 80 per cent of the possible points in all five categories, 58 in four individual scores and another 55 in three out of five. No big leaps or slides in the scores: Average change between -2 and +2 per cent points, maximum of 8 per cent points. 14

Another 77 clinics exceed the average in four of the five scores 27 hospitals collect 80 per cent of the

15 What have we learned? (I) High response quota confirms TK s strategy to include patients satisfaction as an important indicator for Survey seems to deliver stable and therefore reliable results 15

16 What have we learned? (II) Highest correlation for overall satisfaction with the hospital, if satisfied with the result of the hospital treatment. convinced about nurses` care. doctors and nurses took their time to answer questions. convinced about medical treatment. 16

hospital, if satisfied with the result of the hospital treatment.

17 What s next? TK will issue a approx. 60 page confidential report for every hospital included into the survey. This is the basis for the regular managerial discussion between TK (as payer and envoy of its clients) and the clinic. Results are included into the TK-Klinikführer (Internetbased search engine). Next survey will be conducted in

This is the basis for the regular managerial discussion between TK (as payer and envoy

18 Thanks for your time! Markus Jochem Techniker Krankenkasse Versorgungsmanagement Medizinische Information Bramfelder Straße 140 D Hamburg 18

Germany's Statutory Health Insurance:

Germany's Statutory Health Insurance: Structures, Challenges, Benefits Dr. Norbert Klusen CEO of Techniker Krankenkasse (TK), Hamburg American & German Healthcare Forum 2010, University of Minnesota Minneapolis,