Hospital Consumer Assessment of Healthcare Providers and Systems survey response rates are significantly affected by patient characteristics and postoperative outcomes for patients undergoing primary total knee arthroplasty.
Hospital Consumer Assessment of Healthcare Providers and Systems survey response rates are significantly affected by patient characteristics and postoperative outcomes for patients undergoing primary total knee arthroplasty.
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DOI：
10.1371/journal.pone.0257555
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Grauer JN
中科院分区：
文献类型：
--
作者：
Mercier MR;Galivanche AR;David WB;Malpani R;Pathak N;Hilibrand AS;Rubin LE;Grauer JN
医院消费者对医疗保健提供者和系统的评估 (HCAHPS) 调查衡量患者对其医院体验的满意度。少数出院患者返回调查。全膝关节置换术 (TKA) 后最终返回调查的人之间的潜在偏差（无答复偏差）可能会影响调查结果。因此，本研究的目的是评估患者特征与 HCAHPS 调查无反应术后结果之间的关系。选择 2013 年 2 月至 2020 年 5 月期间在同一机构接受住院、选择性、初次 TKA 的所有成年患者进行分析。出院后，所有患者均已收到 HCAHPS 调查问卷。当前研究分析的主要结果是调查结果。分析了患者特征、手术变量和术后 30 天的结果。进行单变量和多变量分析以确定与 HCAHPS 调查返回独立相关的因素。在确定的 4,804 名 TKA 患者中，1,498 名 (31.22%) 返回了 HCAHPS 调查。在控制患者因素的多变量回归分析中，未返回调查的患者更有可能获得较高的美国麻醉学会评分（ASA 评分为 4 或更高，OR = 2.37；P<0.001），并且部分或完全依赖（OR = 2.37；P = 0.037）。同样，未返回调查的患者更有可能再次入院（OR = 1.94；P<0.001）、出院到家以外的地方（OR = 1.52；P<0.001）或住院时间超过 3 天（OR = 1.43；P = 0.004）。 TKA 后，HCAHPS 调查回复率仅为 31.22%，调查的完成情况与多个人口统计和术后变量相关。这些发现表明，HCAHPS 调查结果捕获了真正 TKA 患者群体中不具有代表性的部分。在使用 HCAHPS 调查结果作为医疗保健质量和联邦报销率的指标时，有必要考虑这种偏差。
The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey measures patients’ satisfaction of their hospital experience. A minority of discharged patients return the survey. Underlying bias among who ultimately returns the survey (non-response bias) after total knee arthroplasty (TKA) may affect results of the survey. Thus, the objective of the current study is to assess the relationship between patient characteristics and postoperative outcomes on HCAHPS survey nonresponse. All adult patients at a single institution undergoing inpatient, elective, primary TKA between February 2013 and May 2020 were selected for analysis. Following discharge, all patients had been mailed the HCAHPS survey. The primary outcome analyzed in the current study is survey return. Patient characteristics, surgical variables, and 30-day postoperative outcomes were analyzed. Univariate and multivariate analyses were performed to identify factors independently associated with return of the HCAHPS survey. Of 4,804 TKA patients identified, 1,498 (31.22%) returned HCAHPS surveys. On multivariate regression analyses controlling for patient factors, patients who did not return the survey were more likely to have a higher American Society of Anesthesia score (ASA score of 4 or higher, OR = 2.37; P<0.001), and be partially or totally dependent (OR = 2.37; P = 0.037). Similarly, patients who did not return the survey were more likely to have had a readmission (OR = 1.94; P<0.001), be discharged to a place other than home (OR = 1.52; P<0.001), or stay in the hospital for longer than 3 days (OR = 1.43; P = 0.004). Following TKA, HCAHPS survey response rate was only 31.22% and completion of the survey was associated with several demographic and postoperative variables. These findings suggest that HCAHPS survey results capture a non-representative fraction of the true TKA patient population. This bias is necessary to consider when using HCAHPS survey results as a metric for quality of healthcare and federal reimbursement rates.
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