An empirical study of U.S. hospital quality: Readmission rates, organizational culture, patient satisfaction, and Facebook ratings

Abstract

Reducing hospital readmission rates has been increasingly important as a measure of hospital quality and safety performance. While in recent years hospitals have emphasized the importance of organizational culture as an effective strategy for improving overall hospital performance, there has been a lack of research on the link between organizational culture and readmission rates. In addition, hospitals have been considering the amount of attention they should be paying to unsolicited feedback posted on social media sites like Facebook. Therefore, this study will examine the relationship between organizational culture and readmission rates, and explore whether readmission rates are linked to increased customer satisfaction and, ultimately, to higher hospital Facebook ratings. Survey data collected from 173 hospitals are merged with both publicly available customer satisfaction measures obtained from the Center for Medicare and Medicaid Services (CMS), as well as with data gathered from hospital Facebook sites. Using structural equation modeling, the authors find that a hierarchical culture is the only organizational culture type related to reducing readmission rates. In turn, lower readmission rates are associated with an increased likelihood of patients recommending the hospital and, ultimately, to higher Facebook ratings. This study provides empirical support that hospital administrators should focus on developing a hierarchical culture as a strategy for tackling these rates. The authors’ findings also indicated that hospitals' overall effort to improve hospital readmission rates is related to increased patient satisfaction and public perception of the hospitals, as indicated on public websites such as CMS and Facebook.