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Study examines patient experience at safety-net hospitals

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ScienceCodex writes of a study which suggests that safety-net hospitals (SNHs), which typically care for poor patients, performed more poorly than other hospitals on nearly every measure of patient experience and that could have financial consequences as hospital payments are connected to performance, according to a report published Online First by Archives of Internal Medicine, a JAMA Network publication.

Value-based purchasing (VBP), a program run by the Centers for Medicare and Medicaid Services (CMS), now ties part of each hospital’s payments to its performance on a set of quality measures. Under the program, about 1 percent to 3 percent of total Medicare payments will be held back, and hospitals will receive some portion of that money based on how well they perform on VBP metrics. Part of each hospital’s performance score will be determined using measures of patient-reported experience from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, according to the study background.

Paula Chatterjee, M.P.H., of the Harvard School of Public Health, Boston, and colleagues used the HCAHPS survey in 2007 and 2010 to determine performance and improvement on measures of patient-reported hospital experience among SNHs compared with non-SNHs. Their study included 3,096 U.S. hospitals, of which 769 were in the highest Disproportionate Share Hospital (DSH) index quartile and composed the SNH group.

Safety-net hospitals had lower performance than non-SNHs on nearly all measures of patient experience. The greatest differences were in overall hospital rating, for which patients in SNHs were less likely to rate the hospital a nine or 10 on a 10-point scale compared with patients in non-SNHs (63.9 percent vs. 69.5 percent). There also were sizable gaps for the proportion of patients who reported receiving discharge information (2.6 percentage point difference) and who thought they always communicated well with physicians (2.2 percentage point difference), according to the study results.

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