Does the patient's inherent rating tendency influence reported satisfaction scores and affect division ranking?

OBJECTIVE: To determine the impact of adjusting for rating tendency (RT) on patient satisfaction scores in a large teaching hospital and to assess the impact of adjustment on the ranking of divisions. DESIGN: Cross-sectional survey. SETTING: Large 2200-bed university teaching hospital. PARTICIPANTS: All adult patients hospitalized during a 1-month period in one of 20 medical divisions. INTERVENTION: None. MAIN OUTCOME MEASURES: Patient experience of care measured by the Picker Patient Experience questionnaire and RT scores. RESULTS: Problem scores were weakly but significantly associated with RT. Division ranking was slightly modified in RT adjusted models. Division ranking changed substantially in case-mix adjusted models. CONCLUSIONS: Adjusting patient self-reported problem scores for RT did impact ranking of divisions, although marginally. Further studies are needed to determine the impact of RT when comparing different institutions, particularly across inter-cultural settings, where the difference in RT may be more substantial.