A new study analyzing more than 3,200 hospitals across the United States (U.S.) has revealed stark differences in how patients rate their hospital experiences depending on where they receive care. The research was published June 11, 2025 in the open-access journal PLOS One and led by Man Hung of the University of Utah, U.S., and colleagues.
Patient satisfaction in the United States is known to vary regionally, likely due to cultural, socioeconomic, and infrastructure differences. In the new study, researchers analyzed data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey from 3,286 U.S. hospitals from July 1, 2021 through June 30, 2022. In the HCAHPS survey, patients rated ten specific aspects of their hospital stay, from communication with nurses and doctors to the cleanliness and quietness of hospital rooms.
Across regions, the Midwest emerged as the clear leader in reported patient satisfaction, scoring highest in nearly every category, including staff communication, hospital cleanliness, and overall ratings. Meanwhile, the "Other" region, which included places like Puerto Rico and the District of Columbia, consistently received the lowest scores—especially in critical areas like staff responsiveness and discharge information. Within individual states, New York and South Carolina performed especially poorly, while South Dakota ranked on top in nearly every category.
Across all regions, communication about medications and discharge instructions were consistently among the lowest-rated aspects of care. These are essential elements of care transitions, and poor communication in these areas can lead to complications or hospital readmissions.
The healthcare landscape may well have changed since the 2021-2022 survey was conducted, in the middle of the COVID-19 pandemic. However, the authors conclude that studying high-performing regions and states could help guide policymakers in enhancing national healthcare quality, reducing quality gaps, and ensuring equitable access to high-quality healthcare across the U.S.
The authors add: "While one might expect no significant differences in patient satisfaction among hospitalized patients across the U.S., our findings revealed small but statistically significant regional variations. Encouragingly, overall satisfaction and willingness to recommend the hospital were consistently rated moderately high across all regions."
"Disparities in patient satisfaction between states may indicate a need for policy reform or increased investment, such as funding for hospital improvements or staff training initiatives. These variations could also reflect unequal access to healthcare or differences in care quality among diverse populations."
"Notably, patient satisfaction with the overall hospital experience and willingness to recommend remained moderately high across U.S. regions. However, we were surprised to find that satisfaction scores were lowest for communication about medications and discharge information."
In your coverage, please use this URL to provide access to the freely available article in PLOS One: https://plos.io/43gYYGO
Citation: Hung M, Vu S, Hon ES, Reese L, Gardner J, Lipsky MS (2025) Unveiling the drivers of patient satisfaction in the United States hospitals: Assessing quality indicators across regions. PLoS One 20(6): e0324737. https://doi.org/10.1371/journal.pone.0324737
Author countries: U.S.
Funding: The author(s) received no specific funding for this work.
