Content analysis of patient complaints.

OBJECTIVE To develop a standard taxonomy for inpatient complaints that could be adopted in a wide array of health service institutions. DESIGN A taxonomy was developed by merging the coding schemes from eight prior studies of patient complaints, and then by revising the received coding scheme in light of the codes and clarifications that emerged from a content analysis of patient complaints. SETTING Two Boston area hospitals. PARTICIPANTS Stratified random sample of 1216 complaints from patients in 2004. INTERVENTION s) None. Main outcome measure(s) Patient complaints codes, provider codes and inter-rater reliability. RESULTS A taxonomy comprising 22 patient complaint codes and five provider codes was developed. Inter-rater agreement for complaint codes was good (median Kappa statistic 0.66, interquartile range 0.55-0.80). Four codes were each used in more than 10% of the patient complaints filed: unprofessional conduct (19%); poor provider-patient communication (17%); treatment and care of patient (16%); and, having to wait for care (11%). Of the coding for the profession of the person complained about, 47% of the patient complaints were about staff in general or did not specify a particular profession; 22% identified a physician or dentist; 12% nursing staff; 11% administrative or support staff and 8% allied clinical health professionals. CONCLUSIONS Standardized coding of patient complaint data may provide an opportunity for quality improvement, patient satisfaction and changes in patient care.