Background: Medical provider reimbursement has become increasingly dependent on measurements of patient satisfaction. As crowding in emergency departments (ED) increases in prevalence, associations between the Press Ganey (PG) scores and several markers of crowding in the ED such as wait times, boarding times, and length of stay have been studied. However, there is little research on the association of the PG scores with the National Emergency Department Overcrowding Score (NEDOCS). The objective of this analysis is to understand how ED overcrowding, measured by the NEDOCS, is associated with patient satisfaction.
Methods: Retrospective cross-sectional study of adults treated in a 60,000-visit Midwestern university ED who completed the PG patient satisfaction surveys following their ED discharge (January 2017- November 2018). Patients assessed 1) courtesy of the doctor (courtesy), 2) the degree to which the doctor took the time to listen (listen), 3) doctor’s concern for comfort while treating the patient (comfort), 4) doctor’s concern for keeping the patient informed of treatment (informed), 5) likelihood of recommending the ED to others (recommend), and 6) waiting time (wait) before they were brought to the treatment area on a scale of 0, 25, 50, 75 and 100. This dataset was matched by date and hour of the ED visit to the NEDOCS score that was recorded hourly. Each survey score as an outcome was evaluated for every 25-unit change in NEDOCS score through multinomial logistic regression.
Results: Compared to those rating courtesy 100, the odds of rating it 75 increased by 16% (uOR: 1.10-1.22) for each 25-unit increase in NEDOCS score. The greatest impact was seen with recommend scores; compared to those rating recommend 100, the odds of rating it 0 was 38% times greater (uOR: 1.25-1.52) for each 25-unit increase in NEDOCS score.
Conclusion: Overcrowding is an important factor in ED patient satisfaction. A rising NEDOCS results in significantly lower ratings of physician courtesy and most impacts the likelihood of recommending the ED to others.