ArticleBMJ open2026
What do patients value? A retrospective study of compliment letters from a single institution.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
objectivesThis study aimed to analyse patient-initiated compliment letters from a single institution, identify the key elements that patients value and offer actionable insights to enhance patient-centred care.
designA retrospective, single-institution study using the Healthcare Complaints Analysis Tool (HCAT), text network analysis and latent Dirichlet allocation (LDA) topic modelling on patient compliment letters to pinpoint key valued care elements.
settingA newly established general hospital in Gwangmyeong, South Korea, opened on 22 March 2022.
participantsA total of 1213 compliment letters were collected through the hospital's feedback system, which accepted both online and on-site submissions between 25 March 2022 and 28 June 2024. Letters lacking substantive descriptive content and those containing purely administrative requests were excluded. PRIMARY AND SECONDARY OUTCOME MEASURES: The HCAT was adapted to categorise positive statements into clinical, management and relationship domains, along with six stages of care. Inter-rater reliability was evaluated using Gwet's AC1 statistic. A text network analysis, applying a term frequency-inverse document frequency approach, was conducted to identify prominent keywords. Subsequently, LDA was performed to extract thematic topics.
resultsMost compliments concerned the 'relationship' domain (62%), particularly during the care in the ward stage (56%). Keyword analysis indicated that the most frequently mentioned terms were 'gratitude', 'kindness', 'nurse', 'doctor' and 'heart/mind', underscoring patients' high valuation of positive interactions, professional competence and compassionate communication with medical staff. Topic modelling identified three primary topics, namely, 'appreciation of nursing care' (39%), 'professionalism in surgery and treatment' (35%) and 'effective communication during consultations' (26%).
conclusionsPositive relationships with medical staff, particularly kindness, professionalism and effective communication, influence patient satisfaction. Patient compliment letters serve as important indicators of exceptional care and can inform quality improvement initiatives. Healthcare institutions should leverage these insights to enhance patient-centred services by strengthening patient-provider relationships and promoting a culture of excellence.
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