Abstract
OBJECTIVE: Magnet hospitals exhibit higher patient satisfaction than non-Magnet hospitals, yet the underlying mechanisms driving these differences remain underexplored. This study examined the associations between Magnet status, hospitals' inclusion efforts for diverse populations, and patient satisfaction, and whether inclusion efforts explain Magnet hospitals' higher satisfaction. METHODS: This cross-sectional study analyzed 2023 secondary data from 4 sources: the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), the Healthcare Equality Index (HEI), the American Hospital Association Annual Survey, and the list of Magnet-recognized organizations. The sample included 708 hospitals (216 Magnet, 492 non-Magnet) participating in both HCAHPS and HEI. HEI scores, which assess hospitals' inclusion efforts for lesbian, gay, bisexual, transgender, queer, and other sexual and gender diverse (LGBTQ+) populations, were used as a proxy for overall inclusion. Patient satisfaction was measured using 8 HCAHPS indicators. Mediation analyses tested whether HEI scores explained the association between Magnet designation and patient satisfaction. RESULTS: Magnet hospitals had higher HEI scores (M=92.0, SD=12.2) compared with non-Magnet hospitals (M=88.5, SD=13.3). They also had higher hospital ratings (M=88.4, SD=2.4 vs. M=87.6, SD=3.3) and patient recommendations (M=88.4, SD=3.2 vs. M=86.8, SD=4.1). Magnet status had direct effects on hospital ratings (b=1.75, P <0.001) and recommendations (b=2.37, P <0.001), as well as indirect effects through HEI performance on hospital ratings (b=0.07, P =0.022) and recommendations (b=0.10, P =0.026), resulting in total effects on hospital ratings (b=1.82, P <0.001) and recommendations (b=2.47, P <0.001). CONCLUSIONS: The findings underscore the importance of organizational priorities and policies that promote patient-centeredness and inclusion for the satisfaction of all patients.