Coyne and Messina Articles, Part 2 Statistical Assessment

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Coyneand Messina Articles, Part 2 Statistical Assessment

Thestudy article in Messina’s et al. attempts to answer two researchquestions that state, “How does the satisfaction of patients, andthe number of inpatient cases in acute hospitals relate to theirnature? And does this relationship have a difference when it comes totraining and non-training hospitals?” In general, traininghospitals provide a real hospital environment where physicians andother medical practitioners have the opportunity to get firsthandeducation and experience of working in a healthcare facility. Thestudy tried to find a way of determining the causes of the number ofpatients that come to a hospital for admission and whether thesefigures associate with a prior satisfaction of the patients. Also,the study also looks into whether the relationship between admissionrates and patient satisfaction vary greatly within training andnon-training hospitals. The importance of the research was aboutdetermining factors that affect the volume of inpatient admissions invarious hospitals. The reason is that in the current times, morepatients have higher expectations from the hospitals as theadvancement in the field of medicine has been significant. Besides,the business end of these hospitals also seeks to make a maximumincome that can guarantee their continual operation while stillmeeting all their financial obligations. The results and discussionof the research provided detailed findings that displayed specificanswers for the posed study queries. Furthermore, practicalrecommendations were given that would assist these two categories ofhospitals to increase fulfillment from their patients as well as addup to the volume of inpatient admissions (Messina et al., 2009).


Thesample size involved two sets that each had seven hospitals. Seven ofthese hospitals were non-training while the other seven were traininghospitals. The location of these fourteen hospitals was from thenorth, the central and the south regions of New Jersey. The studyperiod took five years that was between 1999 and 2003. The studysubjects were patients that came from all walks of life. Theircharacteristics varied from age, geographical location, financialstatus, and even their ethnic background. The patients were each senta hardcopy document upon their discharge that had several importantclauses. First of all, they were assured of complete confidentialitywhen it came to their information and medical history. They provisionof a detailed report on the reason for the study and its importancewas another part that was sent to them. Lastly, there was asatisfaction report that gave them a chance to answer directquestions on their satisfaction based on their experience of thehospital that they attended. These questions ranged from servicesthey received such as the admission process, the state of theirrooms, the meals served, general hygiene, the health personnel andthe discharge process. Every aspect of the survey involved ratingsthat varied from 1 to 5. 1 being poor while 5 being very good.Ultimately these findings were projected onto a scale of 0-100(Messina et al., 2009).


Theaggregate admission value for all the hospitals in the time of studywas about 19,111 that ranged from 4, 513 to 70569. The mean value forpatient satisfaction was 82.57. The skewness and kurtosis explanatorystatistics exhibited the admittance numbers as being dispersedordinarily whereas the fulfillment rates were also ordinarilydispersed. The Spearman rank order displayed a negative relationshippostulating that greater patient fulfillment linked to lesser numbersadmissions. Using the Mann-Whitney U-test, the patient fulfillment inthe training hospitals was at 25.76 while the non-training had it at45.24. However, this study involves a sample area that comprises ofless than 20 components. In this study, each of the seven samples wasstudied for five years meaning n= 35. Therefore, a z-test wasconducted. The results showed that the average admissions for thetraining hospitals in those five years was 27, 745 while for thenon-training hospitals was 10, 722. These figures clearly show thattraining hospitals had higher admission rates within those fiveyears. On the contrary, when it came to patient satisfaction, themean satisfaction rate for the training hospitals was 81.54 while thenon-training hospitals had a mean of 83.58. These values show thatnon-training hospitals provide more satisfaction to their patientsthan the training hospitals (Messina et al., 2009).


Thestudy shows that in general, patient satisfaction correlatesnegatively with the inpatient volume. The reason for this would bethat patients are more fulfilled with the services rendered insituations where the total number of patients catered for is fewer.On the other hand, when it comes to the training and non-traininghospitals, the average number of inpatient admissions is much higherin the training hospitals that in the non-training ones. This couldbe due to the complexity of training hospitals and the differentservices and equipment that they have at their disposal. Therefore,more patients prefer these types of hospitals. When it comes to thepatient satisfaction, non-training hospitals have a higher meanvalue. The reason could be because non-training hospitals have fewerpatients, or also the training hospitals have various procedures tofollow through with much more health workers thus, patients rarelyget the full attention that they might want. Therefore, thehealthcare provided might not be as personalized as needed by thepatient (Messina et al., 2009).


Thestudy was able to show that even if the training hospitals led in thenumber of inpatient admissions, they rated lower when it came topatient satisfaction. The research therefore shows that in order forthese hospitals to capture more patients, they have to improve theirservice delivery. Also, the training hospitals should provide moretime for the patients and make them feel wanted. Once they followthis strategy, more patients will be able to come to these hospitalsinclusive of subsequent times.

Assessmentof Research Appropriateness


Data Type

Sample Range

Research Question

Correlation Coefficient



The difference between the two variables that were admission rates and patient satisfaction was that there was more patient satisfaction where there were less numbers of inpatient admissions.

Regression Analysis



The dependent variables were the patient satisfaction and the number of admissions while the independent variables were the training and non-training hospitals. Training hospitals had more numbers of inpatient admissions while having less satisfaction from the patients compared to the non-training hospitals.

Errorsin Table 4

Whenit came to the number of training hospitals, the findings gavefive-year results of 35 samples. However, Table 4 only shows 34hospitals when at the section of admissions in training hospitals.

Thecorrelation coefficient for training hospitals when it comes topatient satisfaction compared to total admissions has a positivevalue. This figure is wrong since the patient satisfaction is lowerin training hospitals and does not increase with the increase inadmissions.

Whenthe satisfaction from the training hospitals is related tosatisfaction from the non-training hospitals, it has a negativecorrelation coefficient. On the other hand, when the patientsatisfaction from non-training hospitals is compared to the traininghospitals, the correlation coefficient is negative.

StatisticalSignificance vs. Pragmatic Usefulness

Thestatistical significance uses mathematical tests to assess whetherthe results of an experiment or research are practical or onlycoincidental. In the case of this study, it is statisticallysignificant since every finding was analyzed using correlationcoefficient and regression analysis. Pragmatic usefulness involvesall the steps taken in a study from the formation of the hypothesis,the procedure, data collection, discussion and recommendations thatsignify whether the research was done correctly. In the case of thisstudy, it attains its pragmatic usefulness as all protocols werefollowed through and working recommendations were suggested (Hinton,2014).


Coyne,J. S., Richards, M. T., Shultz, K., &amp Singh, S. G. (2009).Hospital cost and efficiency: do hospital size and ownership typereally matter?.&nbspJournalof Healthcare Management,&nbsp54(3),163.

Hinton,P. R. (2014).&nbspStatisticsexplained.Routledge.

Messina,D., Scotti, D., Ganey, R., Zipp, G., &amp Mathis, L. (2009). TheRelationship Between Patient Satisfaction and Inpatient AdmissionsAcross Training and Nontraining Hospitals. Journalof Healthcare Management, 54(3),177-89, discussion 189-90. Retrieved from