Health Care in America: The Relationship Between Subjective and Objective Assessments of Hospitals

ABSTRACT: Measuring public service performance is a central issue for modern governments. Less attention, however, has been paid to the similarities and differences between various performance indicators. In particular, we know less about the views of citizens concerning performance and how they are correlated with administrative performance. Examining the growing area of health care, we examine how patient perceptions on service quality are related to a series of objective hospital performance indicators. Regarding the quality of interpersonal care and the process of care, we find convergent validity with patient satisfaction and this validity is relatively consistent across diagnosis types. Patient assessments, however, do not track clinical outcomes, such as mortality. Given the complex context and high levels of information asymmetry in health care, the evidence for convergent validity contributes to the generalizability of the theory linking citizen satisfaction to the provision of public services.