Patient Admission Preferences and Perceptions

• Main Authors: Clayton Wu, Joy Melnikow, Tu Dinh, James F. Holmes, Samuel D. Gaona, Thomas Bottyan, Debora Paterniti, Daniel K. Nishijima
• Format: Article
• Language: English
• Published: eScholarship Publishing, University of California 2015-10-01
• Series: Western Journal of Emergency Medicine
• Subjects: patient preference; health services; intensive care unit; brain injuries
• Online Access: http://escholarship.org/uc/item/0sg7102w
• ISSN: 1936-900X; 1936-9018

Introduction: Understanding patient perceptions and preferences of hospital care is important to improve patients’ hospitalization experiences and satisfaction. The objective of this study was to investigate patient preferences and perceptions of hospital care, specifically differences between intensive care unit (ICU) and hospital floor admissions. Methods: This was a cross-sectional survey of emergency department (ED) patients who were presented with a hypothetical scenario of a patient with mild traumatic brain injury (TBI). We surveyed their preferences and perceptions of hospital care related to this scenario. A closed-ended questionnaire provided quantitative data on patient preferences and perceptions of hospital care and an open-ended questionnaire evaluated factors that may not have been captured with the closed ended questionnaire. Results: Out of 302 study patients, the ability for family and friends to visit (83%), nurse availability (80%), and physician availability (79%) were the factors most commonly rated “very important,” while the cost of hospitalization (62%) and length of hospitalization (59%) were the factors least commonly rated “very important.” When asked to choose between the ICU and the floor if they were the patient in the scenario, 33 patients (10.9%) choose the ICU, 133 chose the floor (44.0%), and 136 (45.0%) had no preference. Conclusion: Based on a hypothetical scenario of mild TBI, the majority of patients preferred admission to the floor or had no preference compared to admission to the ICU. Humanistic factors such as the availability of doctors and nurses and the ability to interact with family appear to have a greater priority than systematic factors of hospitalization, such as length and cost of hospitalization or length of time in the ED waiting for an in-patient bed.