According to a national survey of patients’ experiences, patients in many U.S. hospitals are not satisfied with their care. Many institutions got low marks in a number of basic areas such as pain management and communication, or giving clear discharge instructions.

“Even though we spend $2 trillion on health care, you would think that things like always managing patients' pain in the hospital is something we would have gotten right by now,” said study author Dr. Ashish K. Jha, an assistant professor for health policy at the Harvard School of Public Health.

But the survey reveals that there are some areas in which hospital’s performance is still “pretty suboptimal,” that definitely need improvement. Nearly a third of patients surveyed gave hospitals low marks in pain management, while a fifth of patients were dissatisfied with the way their discharge instructions were communicated.

A government report on medical errors previously released indicated that one of every 10 patients died within 90 days of surgery because of a preventable hospital error and one third of the deaths occurred after the patient was discharged.

Patients at hospitals in Birmingham were more satisfied with their pain care than those in East Long Island: 72% of patients in Birmingham, Ala., hospitals gave their care a 9 or 10, compared with only 50% of patients in East Long Island, New York, Fort Lauderdale, Florida and New York City hospitals.

The report also revealed that for-profit hospitals received lower scores than not-for-profit hospitals.

The report was published in the Oct. 30 issue of the New England Journal of Medicine.