For many years, the medical community has debated whether a positive patient experience (often termed “patient satisfaction”) has an impact on clinical outcomes in the hospital. While a correlation was thought to exist, a new study published March 17 in the Journal of Patient Experience by researchers at Cooper University Health Care shows that there is an association between a positive patient experience and favorable clinical outcomes in U.S. hospitals.
While providing a positive patient experience has always been a focus for hospitals, the issue has become more important in recent years as patient satisfaction data gathered by hospitals is used by the Centers for Medicare and Medicaid Services (CMS) in determining payment to health care organizations. Similarly, some private insurers are also starting to tie a hospital’s patient satisfaction performance to reimbursement rates. To further promote public transparency of hospital performance, in 2015 CMS released new summary star ratings of U.S. hospitals based on their patient experience data.
“While all of these initiatives have been put in place, the relationship between patient experience and clinical outcomes has not been entirely clear, and this has been the subject of controversy in the medical community,” said lead author Stephen W. Trzeciak, MD, MPH, Head of the Division of Critical Care Medicine at Cooper and a Professor of Medicine at Cooper Medical School of Rowan University (CMSRU). “Our goal in this study was to test the association between CMS patient experience star ratings and clinical outcomes by analyzing risk-adjusted data for more than 3,000 U.S. hospitals from the CMS Hospital Compare database.”
The patient experience star-rating system reflects hospitals’ overall performance on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey which covers subjects such as listening and communication by care providers, treatment with respect and courtesy, timeliness of assistance, and quality of discharge instructions.
This information was analyzed along with Medicare claims data from Hospital Compare which looks at clinical outcomes such as complications following treatments or surgery, a variety of hospital acquired infections, joint replacement complications, and readmission rates following certain diagnoses such as stroke, heart attacks, congestive heart failure, and pneumonia, among others.
“When we analyzed the two sets of measures,” Dr. Trzeciak said, “we found a significant association between better patient experience and multiple clinical outcomes, with the most consistent association found between higher star ratings and lower readmission to the hospital.
“Multiple potential theories exist that could explain this association and more study is needed. One theory is that health care providers who are diligent about providing an excellent patient experience may be similarly diligent about excellence in all aspects of patient care. Another theory is that an excellent patient experience may inspire patient confidence and adherence to a treatment plan both in the hospital and following discharge.”
Co-authors of the study included John P. Gaughan, a biostatistician at Cooper; Joshua Bosire, Assistant Vice President of Customer Services and Access at Cooper; and Anthony J. Mazzarelli, MD, JD, MBE, Senior Executive Vice President and Chief Physician Executive and Assistant Professor of Emergency Medicine at CMSRU.
The complete study can be found at http://jpx.sagepub.com/content/3/1/2374373516636681.full.pdf+html
Wendy A. Marano
Cooper University Health Care