Hospital Patient Experience: Exploring Hospitals as Shifters and Sustainers Over Time.

IF 1.2 4区 医学 Q4 HEALTH CARE SCIENCES & SERVICES
Quality Management in Health Care Pub Date : 2024-07-01 Epub Date: 2024-06-26 DOI:10.1097/QMH.0000000000000470
Hanadi Hamadi, Geoffrey A Silvera, Sinyoung Park, Jing Xu, Zhigang Xie
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引用次数: 0

Abstract

Background and objectives: Patient experience is a key factor in measuring hospital performance, and the Hospital Consumer Assessment of Healthcare Providers and Systems survey tool is used to assess patient perceptions. Hospitals with positive patient experience tend to have a better quality of clinical care, lower readmission and mortality rates, and an overall shorter inpatient length of stay. Studies have identified several organizational determinants of high- and low-rated patient experiences, including hospital size, type, staffing levels, and patient demographics.This study aims to explore the determinants of consistently high- and low-rated patient experience, as well as factors associated with positive and negative changes in patient experience over time.

Method: The 2014 to 2019 American Hospital Association annual survey and the Centers for Medicare and Medicaid Services Hospital Value-Based Purchasing database were used. A total of 2801 acute-care hospitals were included in this study. A series of multivariate logistic regressions were used to model the probability of "1" (being a superior hospital or an inferior hospital). In addition, a generalized linear mixed model for binary responses was used to analyze the change (probability of positive and negative change).

Results: The results showed that most hospitals did not sustain superior or inferior performance, and competition decreased the likelihood of a hospital consistently performing well in terms of patient experience. Superior performance was associated with hospital ownership (P < .001), size (P = .026), location (P = .002), teaching status (P = .009), average Herfindahl-Hirschman Index value (P = .005), and Medicaid and Medicare patient population. On the other hand, inferior performance was associated with hospital ownership (P = .003), size (P < .001), teaching status (P = .003), safety net status (P = .020), and Medicaid and Medicare patient population.

Conclusion: This study aimed to examine the trends in hospital patient experience performance and the influence of hospital organizational characteristics on those trends. Our findings allow us to question the widely held belief that patient experience is a metric of differentiation and industry competition, suggesting that performance in this domain has not been utilized by most hospitals as a source of sustainable competitive advantage. The findings from this study highlight the importance of considering changes in performance over time and the need for significant organizational efforts to improve hospital performance in terms of patient experience.

医院患者体验:探索医院随着时间推移的转变和维持。
背景和目的:患者体验是衡量医院绩效的一个关键因素,"医院消费者对医疗保健提供者和系统的评估 "调查工具被用来评估患者的感受。患者体验良好的医院往往拥有更好的临床护理质量、更低的再入院率和死亡率以及更短的住院时间。本研究旨在探讨持续获得高分和低分患者体验的决定因素,以及随着时间的推移患者体验发生积极和消极变化的相关因素:方法:采用 2014 年至 2019 年美国医院协会年度调查和美国医疗保险与医疗补助服务中心医院价值采购数据库。本研究共纳入了 2801 家急诊医院。研究采用了一系列多元逻辑回归来模拟 "1"(成为上级医院或下级医院)的概率。此外,还使用了二元响应的广义线性混合模型来分析变化(正变化和负变化的概率):结果表明,大多数医院并没有持续保持卓越或较差的表现,竞争降低了医院在患者体验方面持续表现良好的可能性。卓越绩效与医院所有权有关(P本研究旨在探讨医院患者体验表现的趋势以及医院组织特征对这些趋势的影响。我们的研究结果使我们能够对 "患者体验是差异化和行业竞争的衡量标准 "这一普遍观点提出质疑,这表明大多数医院并未将这一领域的表现作为可持续竞争优势的来源。这项研究的结果凸显了考虑绩效随时间推移而变化的重要性,以及医院在改善患者体验方面做出重大努力的必要性。
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来源期刊
Quality Management in Health Care
Quality Management in Health Care HEALTH CARE SCIENCES & SERVICES-
CiteScore
1.90
自引率
8.30%
发文量
108
期刊介绍: Quality Management in Health Care (QMHC) is a peer-reviewed journal that provides a forum for our readers to explore the theoretical, technical, and strategic elements of health care quality management. The journal''s primary focus is on organizational structure and processes as these affect the quality of care and patient outcomes. In particular, it: -Builds knowledge about the application of statistical tools, control charts, benchmarking, and other devices used in the ongoing monitoring and evaluation of care and of patient outcomes; -Encourages research in and evaluation of the results of various organizational strategies designed to bring about quantifiable improvements in patient outcomes; -Fosters the application of quality management science to patient care processes and clinical decision-making; -Fosters cooperation and communication among health care providers, payers and regulators in their efforts to improve the quality of patient outcomes; -Explores links among the various clinical, technical, administrative, and managerial disciplines involved in patient care, as well as the role and responsibilities of organizational governance in ongoing quality management.
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