Kaye Gilhooley 2005



The Ministry of Health inpatient satisfaction survey is a mandatory reporting requirement for all public hospitals in New Zealand. Its purpose is to contribute to the monitoring of hospital performance by the Ministry of Health and to facilitate service quality improvements. The research was conducted to investigate whether the Ministry of Health inpatient satisfaction survey fulfils this dual purpose for older person's health services and whether there are other, more appropriate approaches that could be used.


This study used a qualitative method to explore the issues around the usefulness of the Ministry of Health inpatient satisfaction survey in New Zealand. Focused interviews were conducted with a purposefully selected sample of ten key informants who have special interest or expert knowledge in one of the following areas of:

  • Older persons' health services
  • Quality assurance
  • Maori health issues
  • Hospital performance monitoring.
  • Thematic analysis, informed by a general inductive (or post-positivist) approach, was used to identify issues that emerged from the interviews. These were developed into critical evaluation criteria, which were then used to assess the suitability of five patient feedback tools (including the Ministry of Health inpatient satisfaction survey) for use in New Zealand.


The research revealed that the Ministry of Health survey is not adequately meeting either of its dual purposes of improving local service quality or monitoring the performance of public hospitals. None of the patient feedback tools that were assessed fit perfectly with the evaluation criteria. However, two of them fit very well. These are the Hospital Consumer Assessment of Health Plans (HCAHPS�) and the NHS Acute Inpatient Core Questionnaire, both of which are based on the work of the Picker Institute.


This is an important area to study within a public health framework, as decision-makers (both national and local) need effective tools that can be used to provide timely and relevant information on the performance of health service providers so that performance can be managed and improved. Patient feedback on health services is an important component of the wide-ranging information that should be collected. The questionnaire content and methods used to collect this information are vital to the value of patient feedback surveys. Therefore, any patient feedback tool must be carefully designed and administered. This study found that whilst the Ministry of Health survey has merit, it does have some significant weaknesses and does not adequately meet either of its two stated purposes of:

a. measuring performance of public hospitals, and

b. of improving the quality of services to patients.

This research recommends some changes to the inpatient satisfaction tool that will enhance its usefulness both to contribute to performance management and to service quality improvement.

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