STUDY DESIGN.Retrospective cohort study using prospectively collected data.
OBJECTIVE.Determine the association between satisfaction with physician communication and patient-reported outcomes in the ...inpatient spine surgery setting.
SUMMARY OF BACKGROUND DATA.Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys measure the patient experience of care and influence reimbursement for hospital systems and providers in the United States. It is not known whether patient satisfaction with physician communication is associated with better outcomes after spine surgery. Therefore, we evaluated the association between patient satisfaction with physician communication on the HCAHPS survey and improvements in validated patient-reported outcomes measures in a spine surgery population.
METHODS.HCAHPS responses were obtained for patients undergoing elective cervical or lumbar spine surgery from 2013 to 2015. Patient-reported health status measures were the primary outcomes, including EuroQol Five Dimensions (EQ-5D), Pain Disability Questionnaire (PDQ), and Visual Analog Scores for Back and Neck Pain (VAS-BP/NP). The association between satisfaction with communication and preoperative to 1 year postoperative changes in each health status measure was evaluated utilizing multivariable linear regression models.
RESULTS.Our study included 648 patients, of which, 479 (74.4%) created our satisfied cohort. Demographically, our two cohorts were similar with regards to preoperative clinical measures; however, the satisfied cohort had a higher self-rating of their mental health (P < 0.01), and overall health (P < 0.01). After adjusting for clinically relevant confounders, our results demonstrated no significant association between satisfaction with physician communication and improvement in EQ-5D (P = 0.312), PDQ (P = 0.498), or VAS pain scores (P = 0.592).
CONCLUSION.Patient satisfaction with physician communication was not associated with 1-year postoperative improvement in EQ-5D, PDQ, and VAS-Pain after spine surgery. These findings do not diminish the importance of effective communication between doctor and patient, but instead suggest that within the spine surgery setting, using only patient experience data may not accurately reflect the true quality of care received during their inpatient stay.Level of Evidence3
Background: Patient experiences with health care have been widely used as benchmark indicators of quality for providers, health care practices, and health plans. Objective: The objective of this ...study was to summarize the literature regarding the associations between Consumer Assessment of Healthcare Providers and Systems (CAHPS) patient experiences and clinical and quality outcomes. Research Design: A systematic review of the literature was completed using PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature on December 14, 2019. Separate searches were conducted to query terms identifying CAHPS surveys with clinical and quality outcomes of care. Two reviewers completed all components of the search process. Study Selection: Studies investigating associations between CAHPS composite ratings and health care sensitive clinical outcomes or quality measures of care were included in this review. Studies were excluded if they did not investigate patient experiences using CAHPS composite ratings or if CAHPS composites were not treated as the independent variable. Results: Nineteen studies met inclusion criteria, 10 investigating associations of CAHPS composite ratings with clinical outcomes and 9 investigating these associations with quality measures. Patient-provider communication was the most studied CAHPS composite rating and was significantly associated with self-reported physical and mental health, frequency of emergency room visits and inpatient hospital stays, hospitalization length, and CAHPS personal physician global ratings. Conclusions: Ratings of patient experience with care may influence clinical and quality outcomes of care. However, key inconsistencies between studies affirm that more research is needed to solidify this conclusion and investigate how patient experiences differentially relate to outcomes for various patient groups.
Hospital administrators and researchers often use large, standardized surveys that examine patient satisfaction to evaluate whether interventions improve patient experience. To summarize the breadth ...of these interventions and how large, standardized surveys are used to evaluate them, a multidisciplinary research team conducted a review. They used PubMed and Google Scholar searches, reviews of reference lists and targeted searches to locate studies. They evaluated one hundred and twenty-four articles and fifty-eight articles met the inclusion criteria for the narrative review. Using the standard methodology for narrative reviews, the authors synthesize salient themes in the articles and highlight exemplar studies. The review is qualitative, limited, and subjective, and provides a novel analysis of a selection of important and recent research studies. Interventions are in four domains: communication, information and communication technologies (ICT’s), nursing, and the healthcare environment. The majority evaluate patient experiences using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) or the Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS), two widely used, standardized, validated surveys to measure patient experience. Results suggest that verbal, non-verbal, and empathetic communication studies are especially salient in the literature. Research about ICT’s includes promising interventions that need additional testing using large datasets. Finally, many studies evaluate nursing and the healthcare environment, but evaluations of interventions in these areas are often inconclusive because nursing and healthcare environments vary widely within and between hospital systems. The review reveals reliable innovations, inconclusive research, as well as many directions for future research. Experience Framework This article is associated with the Policy & Measurement lens of The Beryl Institute Experience Framework. ( https://www.theberylinstitute.org/ExperienceFramework ). Access other PXJ articles related to this lens. Access other resources related to this lens.
Prior research has demonstrated that the prescription of opioid medications may be associated with the desire to treat pain in order to achieve favorable patient satisfaction. The purpose of the ...current study was to investigate the effect of decreased opioid prescribing following total knee arthroplasty (TKA) on survey-administered patient satisfaction scores.
This study is a retrospective review of prospectively collected survey data for patients who underwent primary elective TKA for the treatment of osteoarthritis (OA) between September 2014 and June 2019. All patients included had completed Hospital Consumer Assessment of Healthcare Providers and Systems (HCAPS) survey information. Patients were stratified into two cohorts based on whether their surgery took place prior to or subsequent to the implementation of an institutional-wide opioid-sparing regimen.
Of the 613 patients included, 488 (80%) were in the pre-protocol cohort and 125 (20%) in the post-protocol cohort. Rate of opioid refills (33.6% to 11.2%; p < 0.001) as well as length of stay (LOS, 2.40 ± 1.05 to 2.13 ± 1.13 days; p = 0.014) decreased significantly after protocol change while rate of current smokers increased significantly (4.1% to 10.4%; p = 0.011). No significant difference was observed in “top box” percentages for satisfaction with pain control (Pre: 70.5% vs Post: 72.8%; p = 0.775).
Protocols calling for reduced prescription of opioids following TKA resulted in significantly lower rates of opioid refills, and were associated with significantly shorter LOS, while causing no statistically significant deleterious changes in patient satisfaction, as measured by HCAPS survey.
III.
This study suggests that HCAPS scores are not negatively impacted by a reduction in postoperative opioid analgesics.
Background: Choosing hospice care for your loved ones is often challenging. Online ratings such as Google rating has become a go-to source for most consumers. The Consumer Assessment of Healthcare ...Providers and Systems (CAHPS) Survey for Hospice also provides quality information about hospice care to help patients and their families make decisions. Aim: To evaluate the perceived usefulness of publicly reported hospice quality indicators and compare hospice Google ratings with hospice CAHPS scores. Methods: A cross-sectional observational study was performed to test the relationship between Google ratings and CAHPS measures in 2020. We conducted descriptive statistics for all variables. Multivariate regressions were used to assess the relationship between Google ratings and the CAHPS scores of the sample. Results: Among our sample of 1,956 hospices, the average Google rating was 4.2 out of 5 stars. CAHPS score means ranged from 75 (Help for pain and symptoms) to 90 (Treating patients with respect) out of 100. Hospice Google ratings were highly correlated with hospice CAHPS scores. For-profit and chain-affiliated hospices reported lower CAHPS scores. Hospice operational time was positively associated with CAHPS scores. The percentage of minority residents in the community and residents’ educational level was negatively associated with CAHPS scores. Conclusions: Hospice Google ratings were highly correlated with patients' and families’ experience scores as measured by the CAHPS survey. Consumers can use information from both resources in making decisions about hospice care.
Background Several studies chronicle profit-making negatively impacting US hospice care quality. However, no study has reported on caregiver satisfaction expressed online by hospice. Objectives ...Assess the relationship between online caregiver sentiment, market share, profit status, and Consumer Assessment of Healthcare Providers and Systems (CAHPS®) scores among the 50 largest US hospices. Methods Retrospective mixed methods of sentiment and multivariate regression analysis. Data sources were online caregiver reviews, provider CAHPS hospice survey data. Results Being a larger, for-profit predicted diminished caregiver and employee satisfaction. Caregiver Sentiment and CAHPS Composite were so highly associated ( r = .862, P < .001), that they are converging on overall caregiver satisfaction. With large effect, CAHPS Star Rating was significantly higher than Review Star Rating. For-profits had significantly higher overall Emotional Intensity than non-profit hospices, again with large effect. Caregiver Sentiment, Review Star Rating, and Glassdoor Composite each predicted CAHPS Composite. Lack of staffing was more frequent among for-profits (13%) than non-profits (6%). Out-of-scope expectations prevalence was 9%. Conclusion Caregiver and employees had better experiences with non-profits than for-profits. Anger and frustration was expressed toward large, for-profit providers more focused on admissions, profiteering, and paying dividends than actual care. The CAHPS appears to draw more satisfied caregivers. Whereas, online reviewing provides open-ended, real-time voicing of care quality concerns. Even with distinct methods, CAHPS survey and review sentiment analysis converge on caregiver satisfaction, yet CAHPS paints a much rosier picture of hospice quality than online reviews. Future research should explore sentiments by topic and hospice to increase customer advocacy.
The raspberry teas are the most common among the national fruit teas. The aim of the study was a consumer assessment of three different raspberry teas with different composition and content of ...raspberries. The survey was conducted in December 2016 among 70 randomly selected students of the Wrocław University of Environmental and Life Sciences. In this study we can observe that a higher content of raspberries in tea were rated better in taste than the tea containing less raspberries. The addition of hibiscus and chokeberry affect a better assessment of the color and flavor of tea. The study had to make the consumers aware of the fact that the name declared on the packaging "Raspberry Tea" does not necessarily reflect its actual composition.
This work proposes a systematic approach for the design of formulated products incorporating consumer assessment and heuristic knowledge. The methodology is divided into two main phases: Consumer ...assessment and product realization. In the first part, product attributes valued by consumers and their interactions are identified through usability tests performed on a reference product, and fuzzy integral analysis. In the second phase, alternative product formulations are generated using a mixed‐integer optimization approach, which incorporates heuristic rules regarding the choice of ingredients and their amounts. The results from the consumer assessment phase are transformed into additional heuristics and incorporated into the design. Different alternative formulations are generated at a lab‐scale, by using two commercial skin moisturizers as references. Those formulations that included additional heuristics are shown to be more similar to the references. As a result, the incorporation of consumer preferences significantly reduced the time and resources spent on the design process.
The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) score is a nationally standardized measure of a patient’s hospital experience. This study aims to assess whether HCAHPS ...scores vary by demographic or surgical factors in patients undergoing primary total hip arthroplasty.
Patients who completed an HCAHPS survey after a primary total hip arthroplasty between October 2011 and November 2016 were included in this study. Patient demographics and surgical factors were evaluated for correlations with individual HCAHPS questions.
One thousand three hundred eighty-three HCAHPS questionnaires were reviewed for this study. Patients with a submitted HCAHPS response had an average age of 63.83 ± 10.17 years. Gender distribution was biased toward females at 57.27% (792 females) versus 42.73% (591 males). The average body mass index (BMI) was 28.68 ± 5.86 kg/m2. Race distribution was predominantly Caucasian at 81.49% (1127 patients), followed by “unknown” at 8.60% (119 patients) and African-American at 8.46% (117 patients). Home discharge occurred for 93.06% (1287 patients) versus 6.94% for facility discharge (96 patients). Mean length of stay was 2.41 ± 1.17 days. Each 1-year increase in age was positively correlated with a 0.16% increase in top-box response rate (β = 0.0016 ± 0.0008; P < .05). Male gender was correlated with a 4.61% increase in top-box response rate when compared to female gender (β = 0.0461 ± 0.0118; P < .01). BMI was found to be correlated with a 0.20% increase in HCAHPS response rates for each 1 kg/m2 increase (β = 0.0020 ± 0.0010; P < .05). For each day increase in length of stay, HCAHPS top-box response rates decrease by 3.41% (β = −0.0341 ± 0.0051; P < .0001). Race, marital status, smoking status, insurance type, and discharge disposition were not found to be significantly correlated with HCAHPS top-box response rate (P > .05).
The HCAHPS quality measurement metric affects physician reimbursement and may be biased by a number of variables including sex, length of stay, and BMI, rather than a true reflection of the quality of their hospital experience. Further research is warranted to determine whether HCAHPS scores are an appropriate measure of the quality of care received.
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