RAND Corporation, Santa Monica, CA.
Health Services Advisory Group, Phoenix, AZ.
Med Care. 2024 Jun 1;62(6):416-422. doi: 10.1097/MLR.0000000000002001. Epub 2024 Apr 12.
HCAHPS' 2008 initial public reporting, 2012 inclusion in the Hospital Value-Based Purchasing Program (HVBP), and 2015 inclusion in Hospital Star Ratings were intended to improve patient experiences.
Characterize pre-COVID-19 (2008-2019) trends in hospital consumer assessment of healthcare providers and systems (HCAHPS) scores.
Describe HCAHPS score trends overall, by phase: (1) initial public reporting period (2008-2013), (2) first 2 years of HVBP (2013-2015), and (3) initial HCAHPS Star Ratings reporting (2015-2019); and by hospital characteristics (HCAHPS decile, ownership, size, teaching affiliation, and urban/rural).
A total of 3909 HCAHPS-participating US hospitals.
HCAHPS summary score (HCAHPS-SS) and 9 measures.
The mean 2007-2019 HCAHPS-SS improvement in most-positive-category ("top-box") responses was +5.2 percentage points/pp across all hospitals (where differences of 5pp, 3pp, and 1pp are "large," "medium," and "small"). Improvement rate was largest in phase 1 (+0.8/pp/year vs. +0.2pp/year and +0.1pp/year for phases 2 and 3, respectively). Improvement was largest for Overall Rating of Hospital (+8.5pp), Discharge Information (+7.3pp), and Nurse Communication (+6.5pp), smallest for Doctor Communication (+0.8pp). Some measures improved notably through phases 2 and 3 (Nurse Communication, Staff Responsiveness, Overall Rating of Hospital), but others slowed or reversed in Phase 3 (Communication about Medicines, Quietness). Bottom-decile hospitals improved more than other hospitals for all measures.
All HCAHPS measures improved rapidly 2008-2013, especially among low-performing (bottom-decile) hospitals, narrowing the range of performance and improving scores overall. This initial improvement may reflect widespread, general quality improvement (QI) efforts in lower-performing hospitals. Subsequent slower improvement following the introduction of HVBP and Star Ratings may have reflected targeted, resource-intensive QI in higher-performing hospitals.
HCAHPS 于 2008 年首次公开报告，于 2012 年纳入医院价值购买计划（HVBP），并于 2015 年纳入医院星级评定，旨在改善患者体验。
描述 COVID-19 之前（2008-2019 年）医院消费者对医疗保健提供者和系统（HCAHPS）评分的趋势。
总体描述 HCAHPS 评分趋势，分阶段描述：（1）首次公开报告期（2008-2013 年）；（2）HVBP 的头两年（2013-2015 年）；（3）初始 HCAHPS 星级评定报告（2015-2019 年）；以及按医院特征（HCAHPS 十分位数、所有权、规模、教学附属关系和城乡）描述。
3909 家参与 HCAHPS 的美国医院。
HCAHPS 综合评分（HCAHPS-SS）和 9 项指标。
大多数积极类别（“最佳框”）的 2007-2019 年 HCAHPS-SS 平均改善率为+5.2%，所有医院均如此（差异 5pp、3pp 和 1pp 分别为“大”、“中”和“小”）。第 1 阶段的改善率最大（+0.8/pp/年，而第 2 阶段和第 3 阶段分别为+0.2pp/年和+0.1pp/年）。改善最大的是医院总体评价（+8.5pp）、出院信息（+7.3pp）和护士沟通（+6.5pp），医生沟通改善最小（+0.8pp）。一些措施在第 2 阶段和第 3 阶段显著改善（护士沟通、员工响应能力、医院总体评价），但其他措施在第 3 阶段则放缓或逆转（药物沟通、安静度）。底层医院的所有措施都比其他医院改善得更多。
所有 HCAHPS 措施在 2008-2013 年迅速改善，尤其是在表现较差的（底层）医院中，缩小了绩效差距，整体提高了分数。这一初步改善可能反映了较低绩效医院的广泛、普遍的质量改进（QI）努力。在 HVBP 和星级评定推出后，后续较慢的改善可能反映了在绩效较高的医院中，有针对性的、资源密集型的 QI。
