Joseph Bellal, Azim Asad, O'Keeffe Terence, Ibraheem Kareem, Kulvatunyou Narong, Tang Andrew, Vercruysse Gary, Friese Randall, Latifi Rifat, Rhee Peter
From the Division of Trauma, Critical Care, Emergency Surgery, and Burns (B.J., A.A.T.O'K., K.I., N.K., A.T., G.V., R.F., R.L., P.R.), University of Arizona, Tucson, Arizona.
J Trauma Acute Care Surg. 2017 Apr;82(4):722-727. doi: 10.1097/TA.0000000000001385.
The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is a data collection methodology for measuring a patient's perception of his/her hospital experience, and it has been selected by the Centers of Medicare and Medicaid Services as the validated and transparent national survey tool with publicly available results. Since 2012, hospital reimbursements rates have been linked to HCAHPS data based on patient satisfaction scores. The aim of this study was, therefore, to assess whether HCAHPS scores of Level I trauma centers correlate with actual hospital performance.
Retrospective analysis of the latest publicly available HCAHPS data (2014-2015) was performed. American College of Surgeons (ACS) verified Level I trauma centers for each state were identified from the ACS registry and then the following data points were collected for each hospital: HCAHPS linear mean scores regarding cleanliness of the hospital, doctor and nurse communication with the patient, staff responsiveness, pain management, overall hospital rating, and patient willingness to recommend the hospital. Our outcome measure were serious complication scores, failure-to-rescue (FTR) scores and readmission-after-discharge scores. Spearman correlation analysis was performed.
A total of 119 ACS verified Level I trauma centers across 46 states were included. The median [IQR] overall hospital rating score for Level I trauma centers was 89 (87-90). The mean ± SD score for serious complication was 0.96 ± 0.266, FTR was 123.06 ± 22.5, and readmission after discharge was 15.71 ± 1.07. The Spearman correlation analysis showed that overall HCAHP-based hospital rating scores did not correlate with serious complications (correlation coefficient = 0.14 p = 0.125), FTR (correlation coefficient = -0.15 p = 0.073), or readmission after discharge (correlation coefficient = -0.18 p = 0.053).
The findings of our study suggest that no correlation exists between HCAHPS patient satisfaction scores and hospital performance for Level I trauma centers. Consequently, the Centers of Medicare and Medicaid Services should reconsider hospital reimbursement decisions based on HCAHP patient satisfaction scores.
Prognostic/epidemiologic study, level III; therapeutic study, level IV.
医院医疗服务提供者与系统消费者评估（HCAHPS）调查是一种用于衡量患者对其医院体验感知的数据收集方法，它已被医疗保险和医疗补助服务中心选为具有公开可用结果的经过验证且透明的全国性调查工具。自2012年以来，医院报销率已根据患者满意度得分与HCAHPS数据挂钩。因此，本研究的目的是评估一级创伤中心的HCAHPS得分是否与医院的实际表现相关。
对最新公开可用的HCAHPS数据（2014 - 2015年）进行回顾性分析。从美国外科医师学会（ACS）登记处识别出每个州经ACS验证的一级创伤中心，然后为每家医院收集以下数据点：关于医院清洁度、医生和护士与患者沟通、工作人员响应能力、疼痛管理、医院总体评分以及患者推荐医院意愿的HCAHPS线性平均得分。我们的结果指标是严重并发症得分、未能挽救（FTR）得分和出院后再入院得分。进行了Spearman相关性分析。
纳入了46个州的119家经ACS验证的一级创伤中心。一级创伤中心的医院总体评分中位数[四分位间距]为89（87 - 90）。严重并发症的平均±标准差得分为0.96±0.266，FTR为123.06±22.5，出院后再入院为15.71±1.07。Spearman相关性分析表明，基于HCAHP的医院总体评分与严重并发症（相关系数 = 0.14，p = 0.125）、FTR（相关系数 = -0.15，p = 0.073）或出院后再入院（相关系数 = -0.18，p = 0.053）均无相关性。
我们的研究结果表明，一级创伤中心的HCAHPS患者满意度得分与医院表现之间不存在相关性。因此，医疗保险和医疗补助服务中心应重新考虑基于HCAHP患者满意度得分的医院报销决策。
预后/流行病学研究，三级；治疗性研究，四级。
