I'm trying to understand patient satisfaction scores and their relevance. (yeah I know... they're irrelevant, yada yada).
For example, Press Gainey takes 30-50 surveys and assigns a score to a physician. According to ACEP,
"for the ED as a whole 30-50 results could provide as low as a 50-55% confidence interval (a flip of a coin to decide whether the results are valid). In order to create the generally accepted 95% confidence interval, 175-225 surveys would be necessary for a scaled (1-5 for example) survey, which is the methodology that the company uses."
ref -
https://www.acep.org/patientsatisfaction/
Seems like perhaps an individual might need a larger amount than 30-50 surveys. Can someone comment on how to calculate the number of surveys needed to provide a 95% CI for an individual? It's been a while since i've taken biostat.
You're making this way too hard. The statistical smokescreens used to obscure the truth about the "patient satisfaction" craze are irrelevant. But the motivation behind patient satisfactions scores themselves isn't "irrelevant." It's incredibly relevant to those that control physicians, nowadays. Chasing patients satisfaction scores is about marketing and money, for administrators and corporate. Period.
Don't get bamboozled by some pseudo-doctor turned administrator, giving a presentation trying to make the concept of patient satisfaction palatable to clinical types by candy-coating it with words like "data," "confidence intervals," and "percentiles." These are persuasion approaches, using techniques to pacify and hypnotize clinical types to comply with corporate culture.
It's no different than when the manager at Applebee's hands out comment cards. It's not scientific. It's not designed to help the waiters. It's not designed to create healthier food choices for the "customers," and reduce heart disease risk amongst the diners. "Percentiles" and "95% confidence intervals" don't mean bunk in this setting. They're just there to make you think there's some scientific basis resembling the science of Medicine, behind it all, so you'll accept it.
They want the unattainable, 100% percent all the time, from everybody, everywhere. They want your blinders on, chasing the rabbit always just beyond your reach. They don't care when science, "medicine" or ethics, clash with the worst impulses of human nature, such as instant gratification, drug addiction and cravings, and demands for irrational over-testing and zero-miss outcome-perfection.
They don't care that when irrational demands for bad and inappropriate medical (the expected unneeded-CT, the inappropriate antibiotics or narcotics demanded) are met with proper and ethical medical care, scores (and cash flow) will suffer. They
want that inappropriate care to continue unabated, and they need your signature on it, to give them plausible deniability. It generates monetary charges and profits. And after all, a "Doctor" signed off on it, as "necessary."
In a fast food joint the customer "is always right." To them, that concept can be applied properly to medical settings. To them, the Hypocratic Oath is as outdated as the wooden teeth worn worn by our founding fathers. They'll never concede that it's wrong, unethical and bad medicine, although they
absolutely know it to be true. They don't care, as long as profits are greater next quarter. Period. Their money, their bottom line are everything and the
only thing. This comes as a shock to doctors. This is not at all surprising to those in the corporate world, which has cannibalized Medicine.
JAMA: Higher patient satisfaction is associated with 1-higher overall health care and prescription drug expenditures, and 2-increased mortality
http://ja.ma/2c4Iacm