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January 28, 2004

Quality of Care and Satisfaction Among Patients Isolated for Infection Control—Reply

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(4):420-422. doi:10.1001/jama.291.4.421-b

In Reply: We agree with the authors of all 3 letters that nosocomial infections represent an important patient safety issue.1 A few points of clarification may be helpful.

First, we doubt that findings about dissatisfaction can be entirely explained by the potentially negative psychological impact of being diagnosed with MRSA, as Dr Parienti suggests. Isolated patients in our general cohort were diagnosed with MRSA during their hospital stay (incident cases), while isolated patients in the disease-specific cohort were diagnosed with MRSA during a previous health care encounter (prevalent cases). Both groups of isolated patients expressed greater dissatisfaction with their treatment than did control patients. In addition, a qualitative review (unpublished data) suggested that the majority of hospital complaints were due to patient perceptions of difficulty in obtaining timely, compassionate, and high-quality care. No complaints explicitly identified patient fears or anger at being diagnosed with MRSA.

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