PHILADELPHIA — Researchers from the University of Pennsylvania School of Nursing conclude patients report higher satisfaction in hospitals that offer better work environments for nurses or smaller patients-to-nurse ratios, according to a new study published in today’s issue of Health Affairs.

The national study is one of the largest to date, involving 98,000 nurses in 430 acute-care hospitals in California, Pennsylvania, New Jersey and Florida.

This research was the first to examine the effects of nurse work environments on patient satisfaction by using data from the National Hospital Consumer Assessment of Healthcare Providers and Systems survey and found:

• The percentage of patients who would definitely recommend a hospital was more than 8 percent higher in hospitals that offered better nurse work environments than ones with poor work environments and more than 4 percent higher in better nurse work environments than average ones.

• For each additional patient per nurse, the percentage of patients who would recommend the hospital increased by 1.44 percent.

• Hospitals that improved their nurse work environments from poor to better and reduced nurses’ workloads by one patient would expect to move from the 16th percentile to the 50th percentile, in terms of percentage of patients who would recommend that facility.

“Improving nurse work environments, including nurse staffing, may improve patients’ experiences and their quality of care,” said Linda Aiken, Penn Nursing professor and lead author of the study.

The Centers for Medicare and Medicaid Services require hospitals to demonstrate patient satisfaction through surveys in order to qualify for full payment, demonstrating the financial incentive for hospitals to enhance patient satisfaction.

The Institute of Medicine has highlighted patient-centered care as one of its six priority areas for improvement in the U.S. health-care system.