Hospital Patient Experience Worsened With the COVID-19 Pandemic, Especially for Older Adults, and Remains Worse than Before.

Adults age 75+ report worse inpatient experiences than patients 55 to 74. Older adults may have been especially vulnerable to changes such as family access and reduced staffing during the COVID-19 pandemic. We examined 2018-2023 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys from 14,760,049 respondents discharged from 4,462 hospitals. We examined changes in an HCAHPS summary score (HCAHPS-SS), controlling for pre-pandemic quarterly and linear trends. HCAHPS-SS declined 4.1pp, a medium-to-large drop by Q3/2022, recovering only slightly by Q4/2023 (to -3.5pp). HCAHPS-SS decreased fastest for patients 75+ and least for maternity patients, even controlling for age. Differences by age may reflect older patients' greater need for instrumental support and differential impacts of visitor restrictions. Hospitals' quality improvement efforts should focus on understanding the need for patient support and on restoring prior patient experience gains. The failure to return to pre-pandemic levels points to the need to understand and address the residual factors that continue to alter patient experience.