Patient-reported experiences with hospitals: comparison of proxy and patient scores using propensity-score matching.

OBJECTIVE

The objective of this study was to compare patient-experience scores between patients with a proxy response and without a proxy response, using propensity-score matching to maximize the comparability between these two groups.

DESIGN

Cross-sectional survey.

SETTING

Hospital inpatient services in Norway.

PARTICIPANTS

Patients were randomly selected from each of the 61 hospitals in Norway during spring 2011. Postal questionnaires were mailed to 23 420 patients after their discharge from hospital.

INTERVENTION

No intervention.

MAIN OUTCOME MEASURES

All of the patient respondents (n = 8744) and the matched cases (n = 734) were compared with patients with a proxy response (n = 734) on 12 patient-experience indicators using t-tests.

RESULTS

Compared with patient respondents, patients with a proxy response had poorer health, were older and were more often discharged from the hospital to another health-care institution (P < 0.001). Patients with a proxy response yielded significantly lower patient-experience scores than those without a proxy response for 9 of the 12 indicators. Compared with the matched patient group, patients with a proxy response had significantly lower scores for 3 of the 12 indicators and a significantly higher score for one indicator. Differences in scores between patients with a proxy response and the matched patient sample were small, with the largest difference being 4 on a scale of 0-100.

CONCLUSIONS

Patients with a proxy response report somewhat poorer experiences than those without a proxy response; however, proxies represent a different patient group than the patient group as a whole, and the results were very similar after controlling for these differences.