Nutrients, Vol. 18, Pages 1246: Fifteen Years of Patient Experience with Hospital Food in a Spanish Long-Term Care Hospital
Nutrients doi: 10.3390/nu18081246
Authors:
M.ª Isabel Ferrero-López
Clara Pérez-Esteve
Mercedes Guilabert Mora
Cristina M.ª Nebot-Marzal
José Mira
Background/Objectives: Adequate nutrition in older adults is essential to maintaining health, functionality, and quality of life, particularly in long-term care hospitals (HACLEs). Previous studies suggest that dissatisfaction with hospital food is linked to longer stays, more complications, and negative perceptions of care. Given these concerns, this study aimed to assess patients’ experiences with hospital food over a 15-year period in a HACLE in Spain, identify key influencing factors, and validate an updated PREM (Patient Reported Experience Measure) tool for food services. Methods: A retrospective, observational, repeated cross-sectional study was conducted using annual PREM surveys administered between 2011 and 2025 to patients on oral diets. Psychometric validation of the updated 8-item version (2024) was conducted. Results: Out of 1618 surveys, 1540 were included in the final analysis. The updated PREM showed strong internal consistency (α = 0.85, ω = 0.87), a two-factor structure (food quality and service conditions), and adequate model fit. Perceptions worsened after a catering company change in 2022 but improved following the implementation of new food distribution carts in 2025. The PREM total score showed a strong positive association with the global satisfaction item, providing supportive evidence based on a closely related anchor measure (Spearman’s rho = 0.80, 95% CI 0.77–0.82; p < 0.001). Scores differed significantly by diet type: patients receiving a pureed diet reported the highest average satisfaction score, followed by those on a soft diet and a regular diet. The group on a soft diet excluding foods that pose a choking hazard had the lowest mean score. Conclusions: The validated PREM scale is a reliable tool to monitor patient experience with hospital food. It enables early detection of quality issues and supports targeted improvements. Routine use in long-term care settings may foster personalized, patient-centered nutrition strategies and enhance care quality.
Background/Objectives: Adequate nutrition in older adults is essential to maintaining health, functionality, and quality of life, particularly in long-term care hospitals (HACLEs). Previous studies suggest that dissatisfaction with hospital food is linked to longer stays, more complications, and negative perceptions of care. Given these concerns, this study aimed to assess patients’ experiences with hospital food over a 15-year period in a HACLE in Spain, identify key influencing factors, and validate an updated PREM (Patient Reported Experience Measure) tool for food services. Methods: A retrospective, observational, repeated cross-sectional study was conducted using annual PREM surveys administered between 2011 and 2025 to patients on oral diets. Psychometric validation of the updated 8-item version (2024) was conducted. Results: Out of 1618 surveys, 1540 were included in the final analysis. The updated PREM showed strong internal consistency (α = 0.85, ω = 0.87), a two-factor structure (food quality and service conditions), and adequate model fit. Perceptions worsened after a catering company change in 2022 but improved following the implementation of new food distribution carts in 2025. The PREM total score showed a strong positive association with the global satisfaction item, providing supportive evidence based on a closely related anchor measure (Spearman’s rho = 0.80, 95% CI 0.77–0.82; p < 0.001). Scores differed significantly by diet type: patients receiving a pureed diet reported the highest average satisfaction score, followed by those on a soft diet and a regular diet. The group on a soft diet excluding foods that pose a choking hazard had the lowest mean score. Conclusions: The validated PREM scale is a reliable tool to monitor patient experience with hospital food. It enables early detection of quality issues and supports targeted improvements. Routine use in long-term care settings may foster personalized, patient-centered nutrition strategies and enhance care quality. Read More