Does length of hospital stay during labor and delivery influence patient satisfaction? Results from a regional study

Abstract

Objective: To examine the relationship between patients' satisfaction with hospital obstetric care, length of stay, and patients' perceived appropriateness of the length of stay.

Study design: A cross-sectional study.

Patients and methods: We surveyed 27,789 women (a 58% response rate) discharged after labor and delivery from 18 hospitals in a large metropolitan region from 1992 through 1994. Patient satisfaction was assessed using the Patient Judgment System, a previously validated instrument. Our analysis focused on four scales evaluating specific aspects of care (physician care, nursing care, provision of information, and preparation for discharge) and two single-item indicators of satisfaction (overall quality and willingness to return to the hospital).

Results: Patients with shorter lengths of stay were more likely (P < 0.001) to perceive their stays as "too short." In addition, the six measures of satisfaction were lower (P < 0.001) in patients who perceived their stays as too short. However, the hypothesized lower satisfaction in patients with shorter stays was not observed; differences in satisfaction according to length of stay were small and of questionable practical significance.

Conclusion: The findings suggest that patients' satisfaction with obstetric care may not depend on the absolute duration of stay but rather on whether patients perceive the length of stay to be adequate. The results are timely because of recent legislation that mandates minimum hospital stays for labor and delivery.