Department of Health Policy and Management, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana.
Division of General Internal Medicine, VA Center for Health Information and Communication, Indiana University School of Medicine, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana.
Health Serv Res. 2020 Oct;55(5):651-659. doi: 10.1111/1475-6773.13556.
To examine the association between receipt of opioids and patient care experiences among nonsurgical hospitalized adults.
A total of 17 691 patient-level responses to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient care experience survey linked to medical records from nonsurgical hospitalizations in an 11-hospital health care system in a Midwestern state, years 2011-2016.
We conducted a pooled cross-sectional study that used propensity score matching analyses and logistic regression to estimate the relationship between patients' care experience measures (overall and pain-specific) and their receipt of opioids while hospitalized. In supplementary analyses, we used the same propensity score matching methods to estimate the relationship between patient care experience measures and receipt of opioids in four patient subgroups based on average patient-reported pain during hospitalization (no pain; mild pain; moderate pain; and severe pain).
Receipt of opioids was not associated with patient care experience measures in our main analysis. In our supplementary analysis, we found lower ratings for pain control among hospitalizations for patients who reported moderate pain (Marginal Effects = -4.5 percent; P value = .015).
Counter to some previous studies, we observed that receipt of opioids was not associated with patient care experience measures for nonsurgical hospitalized adults. These findings may be due to different pain experiences of adults hospitalized for nonsurgical versus surgical reasons.
调查非外科住院成年人接受阿片类药物与患者护理体验之间的关联。
从中西部一个 11 家医院医疗系统的非外科住院患者的医疗记录中，共提取了 17691 名患者对医院消费者评估医疗保健提供者和系统（HCAHPS）患者护理体验调查的个人水平回复，时间跨度为 2011 年至 2016 年。
我们进行了一项汇总的横断面研究，使用倾向评分匹配分析和逻辑回归来估计患者护理体验测量（总体和疼痛特异性）与他们在住院期间接受阿片类药物之间的关系。在补充分析中，我们使用相同的倾向评分匹配方法，根据住院期间患者报告的平均疼痛程度（无疼痛；轻度疼痛；中度疼痛；和严重疼痛），在四个患者亚组中估计患者护理体验测量与接受阿片类药物之间的关系。
在我们的主要分析中，接受阿片类药物与患者护理体验测量无关。在我们的补充分析中，我们发现报告中度疼痛的住院患者的疼痛控制评分较低（边际效应=-4.5%；P 值=.015）。
与一些先前的研究相反，我们观察到非外科住院成年人接受阿片类药物与患者护理体验测量无关。这些发现可能是由于非外科与外科住院患者的疼痛体验不同所致。
