National patient experience data and correlation with in-hospital adverse gynecologic cancer surgical outcomes.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 21-21
Author(s):  
Joseph Dottino ◽  
Weiguo He ◽  
Charlotte C. Sun ◽  
Hui Zhao ◽  
Karen H. Lu ◽  
...  

21 Background: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a patient experience and quality of care measure that impacts hospital reimbursement. HCAHPS data is made available to the public through Centers for Medicare and Medicaid. Given the potential implications for healthcare decision-making, this study sought to determine the utility of hospital-level data from the HCAHPS survey as a predictor of in-hospital postoperative outcomes in gynecologic cancer patients by creating a link with the Nationwide Inpatient Sample (NIS) database, an inpatient care database developed for the Healthcare Cost and Utilization Project (HCUP). Methods: 2009-2011 HCAHPS survey data was used to assign hospitals into terciles by scores. The NIS database was used to identify admissions for cancer-specific surgeries for patients with ovarian, uterine, and cervical cancers. Outcomes included complications, mortality, and prolonged length of stay. Mixed effects models compared correlation of outcomes and HCAHPS scores, after adjustment for patient-level and hospital-level variables. Results: 17,509 linked encounters in 651 hospitals across the U.S. were identified, with 51% uterine, 40% ovarian, and 9% cervical cancer surgical admissions. In-hospital mortality was less likely in hospitals in the highest vs. lowest tercile of summary HCAHPS scores (odds ratio (OR) 0.54, 95% CI: 0.31-0.94). While higher scores were not associated with overall postoperative complications, by complication subcategory, admissions in top tercile hospitals were less likely to have surgical complications (OR 0.82, 95% CI 0.69-0.98). No differences were found in risk of medical or nursing-related complications, or prolonged hospitalization (p > 0.05). Conclusions: For patients undergoing gynecologic oncology surgery, assessment of patient experience has limited correlation with in-hospital adverse surgical outcomes. Awareness of the limitations of HCAHPS survey data may better inform patients as consumers and highlights the importance for transparency of relevant quality measures.

2021 ◽  
Vol 8 ◽  
pp. 237437352110343
Author(s):  
Kimberly A. Indovina ◽  
Angela Keniston ◽  
Venkata Manchala ◽  
Marisha Burden

Hospitals commonly seek to improve patient experience as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, yet there are limited data to guide improvement efforts. The HCAHPS survey was developed for interhospital comparisons, whereas its use in intrahospital comparisons has not been validated. We sought to better understand the validity of utilizing intrahospital score comparisons and to identify the factors that may predict top-box HCAHPS scores. We performed a retrospective observational cohort study at an academic urban safety-net hospital examining 4898 HCAHPS surveys completed by hospitalized patients. We found that while most Patient-Mix Adjustment factors for which HCAHPS scores are adjusted were associated with top-box scores on intrahospital comparisons, few additional variables were associated with top-box scores. Further, HCAHPS questions pertaining to nurse and doctor communication were highly correlated with overall hospital rating, suggesting that communication-related factors may influence a patient’s hospital experience more strongly than do administrative factors.


2021 ◽  
Vol 27 (Supplement_1) ◽  
pp. S53-S54
Author(s):  
Tina Aswani Omprakash ◽  
Norelle Reilly ◽  
Jan Bhagwakar ◽  
Jeanette Carrell ◽  
Kristina Woodburn ◽  
...  

Abstract Background Inflammatory bowel disease (IBD) is a debilitating intestinal condition, manifesting as Crohn’s disease (CD), ulcerative colitis (UC) or indeterminate colitis (IC). The patient experience is impacted by a lack of awareness from other stakeholders despite growing global disease prevalence. To gain deeper insight of the patient experience, promote quality care, and enhance quality of life, we performed a qualitative study of the patient journey starting from pre-diagnosis through treatment. Methods U.S. patients with IBD were recruited via UC/CD support groups and organizations, social media platforms, blog followers, and personal networks. Participants were screened via an emailed survey and asked to self-identify as medically diagnosed on the basis of reported diagnostic testing. Interviews were conducted by qualitative researchers by phone or web conferencing. Open-ended questions were developed to support and gather information about our learning objectives—primarily, our desire to understand the unique experiences of UC/CD patients in their journey from symptom onset through diagnosis, treatment and maintenance (e.g. “Upon diagnosis, what were your immediate thoughts about the condition?”). This qualitative data were analyzed using Human-Centered Design methodology, including patient typologies (personas), forced temporal zoom (journey maps), forced semantic zoom (stakeholder system mapping), and affinity mapping for pattern recognition of unmet needs. Results A total of 32 patients were interviewed: N=17 CD patients, N=13 UC patients and N=2 IC patients. The interviewed population reflected regional, demographic, and disease-related diversity (Table 1). Five unique, mutually exclusive journeys were identified to understand and classify patient experiences: (1) Journey of Independence, (2) Journey of Acceptance, (3) Journey of Recognition, (4) Journey of Passion and (5) Journey of Determination (Figure 1). Patients with IBD expressed a need for increased awareness, education, and training for providers to shorten the path to diagnosis. Mental health support was found to be a critical gap in care, particularly for major treatment decisions (e.g., surgery). The inclusion of emotional support into the treatment paradigm was perceived as essential to long-term wellness. Patient attitudes and self-advocacy varied on their individual journeys; understanding these journeys may accelerate time to diagnosis and treatment. Conclusion Better understanding of patient journeys can help healthcare providers improve their approach to patient care and coordination.


2020 ◽  
Author(s):  
Takuya Aoki ◽  
Yosuke Yamamoto ◽  
Tomoaki Nakata

Objectives. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a well-established and internationally recognized scale for measuring patient experience with hospital inpatient care. This study aimed to develop a Japanese version of the HCAHPS and to examine its structural validity, criterion-related validity, and internal consistency reliability. Design. Multicenter cross-sectional study. Setting. A total of 48 hospitals in Japan. Participants. Patients aged ≥ 16 years who were discharged from the participating hospitals. Results. We translated the HCAHPS into Japanese according to the guidelines. Psychometric properties were examined using data from 6,522 patients. A confirmatory factor analysis showed excellent goodness of fit of the same factor structure as that of the original HCAHPS, with the following composites: communication with nurses, communication with doctors, responsiveness of hospital staff, hospital environment, communication about medicines, and discharge information. All hospital-level Pearson correlation coefficients between the Japanese HCAHPS composites and overall hospital rating exceeded the criteria. Results of inter-item correlations indicated adequate internal consistency reliability. Conclusions. We developed the Japanese HCAHPS, and evaluated its structural validity, criterion-related validity, and internal consistency reliability. This scale could be used for quality improvement based on the assessment of patient experience with hospital care and for health services research in Japan.


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