Adjusting for Patient Characteristics When Analyzing Reports From Patients About Hospital Care

OBJECTIVES: To determine which patient characteristics are associated with reports and ratings of hospital care, and to evaluate how adjusting reports and ratings for hospital differences in such variables affects comparisons among hospitals. DESIGN: A telephone survey of a sample of patients hospitalized in 22 hospitals in a single city and a statewide mail survey of hospitalized patients. MEASURES: The surveys assessed: respect for patients' preferences, coordination of care, information exchange between patient and providers, physical care, emotional support, involvement of family and friends, and transition and continuity. The surveys also asked patients to rate their doctors, nurses, and other hospital staff. RESULTS: The variables with the strongest and most consistent associations with patient-reported problems were age and reported health status. Patient gender and education level also sometimes predicted reports and/or ratings. Models including these variables explained only between 3% and 8% of the variation in reports and ratings. CONCLUSIONS: The impact of adjusting for patient characteristics on hospital rankings was small, although a larger impact would be expected when comparing hospitals with more variability in types of patients. Nevertheless, we recommend adjusting at least for the most important predictors, such as age and health status. Such adjustment helps alleviate concerns about bias. It also may be useful to present data for certain groups of patients (ie, medical, surgical, obstetric) separately to facilitate interpretation and quality improvement efforts

Family medicine · Health care · MEDLINE · Patient satisfaction · Healthcare Policy and Management · Medicine · Nursing · Patient Satisfaction in Healthcare · Patient-Provider Communication in Healthcare

• Patient's Satisfaction with Health Care

  Nada Spasojevic, B Hrabac et al.•Materia Socio Medica•2015

  Incluir item

• Are Comparisons of Patient Experiences Across Hospitals Fair? A Study in Veterans Health Administration Hospitals

  Paul D Cleary, Mark Meterko et al.•Medical Care•2014

  Incluir item

• How does satisfaction with the health-care system relate to patient experience?

  Open Access•Sara N Bleich, Sara Bleich•Bulletin of the World Health…•2009

  Incluir item

• Patient satisfaction with a hospital’s arts-enhanced environment as a predictor of the likelihood of recommending the hospital

  Jana Kay Slater, Marc T Braverman et al.•Arts & Health•2016

  Incluir item

• Patient-perceived responsiveness of primary care systems across Europe and the relationship with the health expenditure and remuneration systems of primary care doctors

  Open Access•Anna Maria Murante, Chiara Seghieri et al.•Social Science & Medicine•2017

  Incluir item

• Comparison of patient perceived primary care quality in public clinics, public hospitals and private clinics in rural China

  Open Access•Wenhua Wang, Elizabeth Maitland et al.•International Journal for Equity…•2017

  Incluir item

• Mental health and satisfaction with primary health care in female patients

  Open Access•Ariel J Lang, Carie S Rodgers et al.•Women s Health Issues•2005

  Incluir item

• Do Medical Inpatients Who Report Poor Service Quality Experience More Adverse Events and Medical Errors

  Benjamin B Taylor, Edward R Marcantonio et al.•Medical Care•2008

  Incluir item

• The Effect of Hospital Size and Teaching Status on Patient Experiences With Hospital Care

  Ingeborg Strømseng Sjetne, Marijke Veenstra et al.•Medical Care•2007

  Incluir item

• Impact of Cross-level Measurement Noninvariance on Hospital Rankings Based on Patient Experiences With Care in 7 European Countries

  Benedict O Orindi, Benedict Orindi et al.•Medical Care•2017

  Incluir item

• Do Differential Response Rates to Patient Surveys Between Organizations Lead to Unfair Performance Comparisons

  Catherine L Saunders, Marc N Elliott et al.•Medical Care•2016

  Incluir item

• Patient Experiences With Information in a Hospital Setting

  Marijke Veenstra, Dag Hofo et al.•Medical Care•2003

  Incluir item

• Dimensions of Plan Performance for Sick and Healthy Members on the Consumer Assessments of Health Plans Study 2.0 Survey

  Alan M Zaslavsky, Paul D Cleary•Medical Care•2002

  Incluir item

• HIV Patients’ Experiences With Inpatient and Outpatient Care

  Ira B Wilson, Lin Ding et al.•Medical Care•2002

  Incluir item

• Patient satisfaction revisited

  Open Access•Karin Dorieke Hekkert, Karin Hekkert et al.•Social Science & Medicine•2009

  Incluir item

• Health systems' responsiveness and reporting behaviour

  Open Access•Nicole Valentine, Emese Verdes-Tennant et al.•Social Science & Medicine•2015

  Incluir item

• Patient and Hospital Characteristics Associated With Patient Assessments of Hospital Obstetrical Care

  Beth S Finkelstein, Jagdip Singh et al.•Medical Care•1998

  Incluir item

• On Studying the Discourse of Medical Encounters

  Howard Waitzkin•Medical Care•1990

  Incluir item

• Psychometric Properties of the CAHPSTM 1.0 Survey Measures

  Ron D Hays, James A Shaul et al.•Medical Care•1999

  Incluir item

• A Causal Model of Health Status and Satisfaction With Medical Care

  Judith A Hall, Michael A Milburn et al.•Medical Care•1993

  Incluir item

• Patient Satisfaction With Hospital Care

  Gary J Young, Mark Meterko et al.•Medical Care•2000

  Incluir item

• Patient Characteristics That Influence Physician Behavior

  Elizabeth M Hooper, Loretto M Comstock et al.•Medical Care•1982

  Incluir item

• Effect of Patient Age on Duration of Medical Encounters With Physicians

  Emmett B Keeler, David H Solomon et al.•Medical Care•1982

  Incluir item

• Age and health status in a patient satisfaction survey

  Open Access•G Cohen•Social Science & Medicine•1996

  Incluir item