Department of Neurosurgery, Duke University Medical Center, Durham, NC.
Department of Anesthesiology, Duke University Medical Center, Durham, NC.
Pain Physician. 2020 Jan;23(1):17-24.
Pain control is strongly correlated with the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) quality-of-care domains and overall hospital experience. Prior research implicates several factors in the variability of patients' pain management satisfaction scores, including but not limited to racial diversity, ethnic diversity, gender, socioeconomic status, and other cultural factors.
In this study, we examined responses to the HCAHPS survey in order to assess factors associated with patient-reported experiences of pain management.
The study design involved a retrospective analysis of patient survey responses.
The research took place at a university-affiliated tertiary hospital.
The study was conducted in a university-affiliated tertiary hospital. Records for adult patients discharged between October 2015 and June 2017 were included. We obtained all patient responses to the HCAHPS pain management questions. We then performed a systematic statistical analysis to evaluate interactions between demographic factor variables and responses to the HCAHPS pain management questions.
Between October 2015 and June 2017, 107,287 patients were discharged from the hospital. Of these, 13,026 of the respondents answered at least one of the HCAHPS pain management questions. Among HCAHPS pain-domain respondents, "Hispanic" and "Black or African American" respondents are more likely to report successful Pain Control when compared to "Not Hispanic" and "Caucasian/White," respectively (odds ratios [ORs] 1.60, 1.22). Additionally, among women, "Black or African American" respondents are more likely to report positive Staff Helpfulness than "Caucasian/White" respondents (OR 1.38).However, we also identified corresponding associations among HCAHPS pain-question responding and patient race/ethnicity: "Hispanic" and "Black/African American" patients were each less likely to respond to the HCAHPS pain questions (ORs 2.03, 2.74).
The primary limitation to this study was nonresponse bias; nevertheless, this is likely to be similar to bias experienced at other institutions. Additionally, this is a single institution study; however, given that the institution has a very large catchment area, we believe the results could be generalized to other settings.
Response rates and responses to HCAHPS pain questions vary by race/ethnicity and sex. It appears likely that Hispanic and Black/African American patients underreport negative experiences. As HCAHPS surveys are used to inform decision-making within the US health care system, demographic biases in the survey data could lead to biases in care and resource allocation.
Pain, HCAHPS, patient reported outcome measures, patient satisfaction, ethnicity, race.
疼痛控制与医院消费者评估医疗保健提供者和系统（HCAHPS）的护理质量领域和整体医院体验密切相关。先前的研究表明，患者疼痛管理满意度评分的变化与几个因素有关，包括但不限于种族多样性、民族多样性、性别、社会经济地位和其他文化因素。
在本研究中，我们检查了 HCAHPS 调查的回复，以评估与患者报告的疼痛管理体验相关的因素。
研究设计涉及对患者调查回复的回顾性分析。
该研究在一所大学附属医院进行。
该研究在一所大学附属医院进行。纳入 2015 年 10 月至 2017 年 6 月出院的成年患者的记录。我们获得了所有患者对 HCAHPS 疼痛管理问题的回复。然后，我们进行了系统的统计分析，以评估人口统计学因素变量与 HCAHPS 疼痛管理问题回复之间的相互作用。
在 2015 年 10 月至 2017 年 6 月期间，有 107287 名患者从医院出院。在这些患者中，有 13026 名患者回答了 HCAHPS 疼痛管理问题中的至少一个问题。在 HCAHPS 疼痛域的受访者中，与“非西班牙裔”相比，“西班牙裔”和“黑种人或非裔美国人”受访者更有可能报告成功的疼痛控制（比值比[OR]分别为 1.60 和 1.22）。此外，在女性中，与“白种人/高加索人”相比，“黑种人/非裔美国人”受访者更有可能报告工作人员的帮助（OR 为 1.38）。然而，我们还在 HCAHPS 疼痛问题回复和患者种族/民族之间发现了相应的关联：“西班牙裔”和“黑种人/非裔美国人”患者回复 HCAHPS 疼痛问题的可能性均较低（OR 分别为 2.03 和 2.74）。
本研究的主要局限性是非应答偏倚；然而，这可能与其他机构经历的偏倚相似。此外，这是一项单机构研究；然而，由于该机构的服务范围非常广泛，我们相信研究结果可以推广到其他环境。
应答率和对 HCAHPS 疼痛问题的回复因种族/民族和性别而异。西班牙裔和黑种人/非裔美国人患者可能会低估负面体验，这似乎是合理的。由于 HCAHPS 调查用于为美国医疗保健系统内的决策提供信息，调查数据中的人口统计学偏差可能导致护理和资源分配的偏差。
疼痛、HCAHPS、患者报告的结果测量、患者满意度、种族。
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