Child Inpatients and Satisfaction: Does patient vs caregiver completion of the satisfaction survey matter?


Child Inpatients and Satisfaction: Does patient vs caregiver completion of the satisfaction survey matter?
March 31, 2023 MHO

Are children happy with the mental health care they receive? While this may seem like a simple question, finding the answer is more complex than it appears. One might wonder if young children are capable of completing satisfaction surveys in a meaningful way, or if perhaps it would be better for their caregiver to provide the feedback instead. One way to explore this question is to compare the results of child satisfaction surveys based on who completed them.


Who is completing satisfaction surveys?

MHO’s data from over 22,000 inpatient child (ages 5-12) discharges from 2020-2023 reveal the vast majority of these children ’speak’ for themselves in terms of satisfaction. In fact, children completed their own satisfaction survey 97.5% of time.  Even amongst the youngest of patients, 5 years old, an overwhelming 93.2% still completed their own survey.


Do children and caregivers have similar levels of satisfaction?

It’s complicated. While children have slightly higher average satisfaction than caregivers (4.41 vs 4.33), children are also more likely to fall into the category of detractors whereas caregivers are more likely to fall into the category of promoters (Figure 1). This discrepancy in Net Promoter item response ultimately yields a much lower Net Promoter Score in children versus caregivers (38.5 vs 68.5).


Children are more likely to be detractors and report a lower Net Promoter Score than caregivers.

The age of the child seems to play a role in the child’s satisfaction as well, where younger children report slightly higher average satisfaction and Net Promoter Score (Figure 2). This finding is consistent with longstanding satisfaction patterns in MHO’s data, where adolescent patients are amongst the least satisfied of all patients. It seems lowered adolescent satisfaction begins to show up in late childhood.

Net Promoter Score and Average Satisfaction for patient completed surveys vary by patient age.

What can facilities learn from these data?


Children hold their own opinions on the care they receive, and it does not always align with caregiver opinions. Listening to the perspective of child patients when evaluating the quality of care is crucial, as their attitudes compared to their caregivers may be more closely associated with compliance and engagement with treatment[1].


While child inpatients generally appear to be satisfied with their care, satisfaction does vary by age. Therefore, it’s essential for facilities to pay close attention to the needs and expectations of different developmental stages. By doing so, facilities can ensure children receive the best possible care, leading to better engagement, compliance, and outcomes as well as better satisfaction ratings for the facilities.

[1] Barber, A. J., Tischler, V. A., & Healy, E. (2006). Consumer satisfaction and child behavior problems in child and adolescent mental health services. Journal of Child Health Care, 10(1), 9–21.