This article addresses satisfaction with physician care as a determining factor for admission, ER use, adherence to medical plan of care as it may relate to mortality, and so forth. They also say that they aren't really making any conclusions about why these data are what they are-- your "tied to" doesn't mean "caused by." Association isn't causation.
Nothing at all about nursing. Of course, it IS the JAMA. From the Comments section at the end of the paper (my emphasis in bold):
"Limitations include, first, that the patient satisfaction measure addressed satisfaction with the physician and not other domains of health care satisfaction
, although satisfaction with one's physician correlates with other satisfaction dimensions and with global satisfaction.24
Second, regardless of physician actions, patients may also have fundamental tendencies to be more or less satisfied that are associated with distinct care-seeking patterns; it is possible that patients who are likely to receive discretionary care may also be predisposed to express high satisfaction with their physicians. Third, we assessed the relationship between patient satisfaction in one year and health care utilization and expenditures in the following year, which may differ from the relationship between sustained patient satisfaction and longer-term utilization and expenditures.
"Advocates of patient experience metrics argue that systematic routine measurement of patient satisfaction is a powerful quality improvement tool for physicians and health plans.1
While we do not believe that patient satisfaction should be disregarded, our data suggest that we do not fully understand what drives patient satisfaction as now measured or how these factors affect health care use and outcomes. Therapeutic responsibilities often require physicians to address topics that may challenge or disturb patients, including substance abuse, psychiatric comorbidity, nonadherence, and the risks of requested but discretionary tests or treatments. Relaxing patient satisfaction incentives may encourage physicians to prioritize the benefits of truthful therapeutic discourse, despite the risks of dissatisfying some patients.
"In a nationally representative sample, higher patient satisfaction was associated with increased inpatient utilization and with increased health care expenditures overall and for prescription drugs. Patients with the highest degree of satisfaction also had significantly greater mortality risk. These associations warrant cautious interpretation and further evaluation, but they suggest that we may not fully understand the factors associated with patient satisfaction. Without additional measures to ensure that care is evidence based and patient centered, an overemphasis on patient satisfaction could have unintended adverse effects on health care utilization, expenditures, and outcomes."