Yousif M Hydoub, Karen M Fischer, Kristine T Hanson, Trevor J Coons, Laurie L Wilshusen, Tafi L Vista, Gretchen A Colbenson, M Caroline Burton, Elizabeth B Habermann, Sagar B Dugani
{"title":"Multisite analysis of patient experience scores and risk of hospital admission: a retrospective cohort study.","authors":"Yousif M Hydoub, Karen M Fischer, Kristine T Hanson, Trevor J Coons, Laurie L Wilshusen, Tafi L Vista, Gretchen A Colbenson, M Caroline Burton, Elizabeth B Habermann, Sagar B Dugani","doi":"10.1080/21548331.2022.2144055","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Routinely collected patient experience scores may inform risk of patient outcomes. The objective of the study was to evaluate the risk of hospital admission within 30-days following third-party receipt of the patient experience survey and guide interventions.</p><p><strong>Methods: </strong>In this retrospective cohort study, we analyzed Hospital Consumer Assessment of Healthcare Providers and Systems surveys, January 2016-July 2019, from an institution's 20 hospitals in four U.S. states. Surveys were routinely sent to patients using census sampling. We analyzed surveys received ≤60 days following discharge from patients living ≤60 miles of any of the institution's hospitals. The exposures were 19 survey items. The outcome was hospital admission within 30 days after third-party receipt of the survey. We evaluated the association of favorable (top-box) vs unfavorable (non-top-box) score for survey items with risk of 30-day hospital admission in models including patient and hospitalization characteristics and reported adjusted odds ratios (aOR [95% confidence interval]).</p><p><strong>Results: </strong>Among 40,162 respondents (mean age ± standard deviation: 68.1 ± 14.0 years), 49.8% were women and 4.3% had 30-day hospital admission. Patients with 30-day hospital admission, compared to those not admitted, were more likely to be discharged from a medical service line (62.9% vs 42.3%; <i>P</i> < 0.001) and have a higher Elixhauser index. Favorable vs unfavorable score for <i>hospital rating</i> was associated with lower odds of 30-day hospital admission in the overall cohort (0.88 [0.77-0.99]; <i>P</i> = 0.04), medical service line (0.81 [0.70-0.94]; <i>P</i> = 0.007), and upper tertile of Elixhauser index (0.79 [0.67-0.92]; <i>P</i> = 0.003). Favorable score for <i>recommend hospital</i> was associated with lower odds of 30-day hospital admission in the medical service line (0.83 [0.71-0.97]; <i>P</i> = 0.02) but for others (e.g. <i>cleanliness of hospital environment</i>) showed no association.</p><p><strong>Conclusion: </strong>In routinely collected patient experience scores, favorable <i>hospital rating</i> was associated with lower odds of 30-day hospital admission and may inform risk stratification and interventions. Evidence-based survey items linked to patient outcomes may also inform future surveys.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9928911/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hospital practice (1995)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/21548331.2022.2144055","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/11/24 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Routinely collected patient experience scores may inform risk of patient outcomes. The objective of the study was to evaluate the risk of hospital admission within 30-days following third-party receipt of the patient experience survey and guide interventions.
Methods: In this retrospective cohort study, we analyzed Hospital Consumer Assessment of Healthcare Providers and Systems surveys, January 2016-July 2019, from an institution's 20 hospitals in four U.S. states. Surveys were routinely sent to patients using census sampling. We analyzed surveys received ≤60 days following discharge from patients living ≤60 miles of any of the institution's hospitals. The exposures were 19 survey items. The outcome was hospital admission within 30 days after third-party receipt of the survey. We evaluated the association of favorable (top-box) vs unfavorable (non-top-box) score for survey items with risk of 30-day hospital admission in models including patient and hospitalization characteristics and reported adjusted odds ratios (aOR [95% confidence interval]).
Results: Among 40,162 respondents (mean age ± standard deviation: 68.1 ± 14.0 years), 49.8% were women and 4.3% had 30-day hospital admission. Patients with 30-day hospital admission, compared to those not admitted, were more likely to be discharged from a medical service line (62.9% vs 42.3%; P < 0.001) and have a higher Elixhauser index. Favorable vs unfavorable score for hospital rating was associated with lower odds of 30-day hospital admission in the overall cohort (0.88 [0.77-0.99]; P = 0.04), medical service line (0.81 [0.70-0.94]; P = 0.007), and upper tertile of Elixhauser index (0.79 [0.67-0.92]; P = 0.003). Favorable score for recommend hospital was associated with lower odds of 30-day hospital admission in the medical service line (0.83 [0.71-0.97]; P = 0.02) but for others (e.g. cleanliness of hospital environment) showed no association.
Conclusion: In routinely collected patient experience scores, favorable hospital rating was associated with lower odds of 30-day hospital admission and may inform risk stratification and interventions. Evidence-based survey items linked to patient outcomes may also inform future surveys.