Characteristics and Predictors of HCAHPS Nonresponse After Spine Surgery.
Characteristics and Predictors of HCAHPS Nonresponse After Spine Surgery.
复制标题
脊柱手术后 HCAHPS 无反应的特征和预测因素。
DOI：
10.1097/brs.0000000000003287
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发表时间：
2020
期刊：
影响因子：
3
通讯作者：
Grauer,JonathanN
中科院分区：
文献类型：
--
作者：
Malpani,Rohil;Adrados,Murillo;Mercier,MichaelR;McLynn,RyanP;Galivanche,AnoopR;Pathak,Neil;Grauer,JonathanN
研究设计。回顾性队列研究。目的：评估脊柱手术后HCAHPS调查的无应答偏倚。背景资料摘要。医院消费者对医疗服务提供者和系统的评估（HCAHPS）调查是一项公开报告的患者满意度调查。除了有可能影响医院的声誉外，它还与政府报销直接相关。方法：选取2013年1月至2017年8月在同一医院接受脊柱外科手术的所有成人住院患者进行回顾性分析。患者人口统计学和围手术期结果被评估为不返回HCAHPS调查的潜在预测因素。结果：在5517例脊柱手术中，1505例（27.3%）患者返回了HCAHPS调查。反应率根据患者特征（年龄、功能状态、种族和美国麻醉医师学会评分有统计学显著差异）而变化，但根据脊柱手术的解剖区域没有变化。多因素分析显示，未返回HCAHPS调查的患者多为黑人/非裔美国人（OR= 2.8， P< 0.001），美国麻醉医师学会评分较高（OR 1.76， P< 0.001），发生过严重不良事件（OR= 1.66， P= 0.001）、轻微不良事件（OR= 2.50， P< 0.001），出院后转往非家乡（OR= 2.16， P< 0.001），再入院（OR= 2.58， P< 0.001）；P< 0.001)，住院时间较长（OR= 1.28， P= 0.001）。对于脊柱手术患者，HCAHPS调查发现患者特征和围手术期结果与无反应偏倚显著相关。虽然不能直接确定HCAHPS评分中潜在的偏倚，但考虑到在研究人群中实际完成这项调查的患者不到三分之一，在解释此类满意度调查的结果时必须考虑到这一点。证据水平：3医院消费者对医疗服务提供者和系统的评估（HCAHPS）调查是一项公开报告的患者满意度调查。在同一家机构进行的5517例脊柱手术中，只有27.3%的患者回复了HCAHPS的调查。调查返回率与确定的患者特征和围手术期结果显著相关。
Study Design.Retrospective cohort study.Objective.To assess nonresponder biases for the HCAHPS survey following spine surgery.Summary of Background Data.The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is a publicly reported patient satisfaction survey. In addition to having the potential of impacting a hospital's reputation, it is directly linked to government reimbursement. However, it is known that a minority of patients return this survey, and it is expected that there are nonresponder biases.Methods.All adult inpatient spine surgery patients at a single institution between January 2013 and August 2017 at a single institution were selected for retrospective analysis. Patient demographics and perioperative outcomes were assessed as potential predictors of not returning HCAHPS surveys. Univariate and multivariate analyses were performed.Results.Of 5517 spine surgeries analyzed, 1505 (27.3%) patients returned the HCAHPS survey. Response rate was variable based on patient characteristics (with statistically significant differences based on age, functional status, race, and American Society of Anesthesiologists score) but not variable based on anatomic region of the spine surgery. Multivariate analysis revealed that patients who did not return the HCAHPS survey were more likely to be black/African American (OR= 2.8, P< 0.001), have a higher American Society of Anesthesiologists score (OR 1.76, P< 0.001), and have had a major adverse event (OR= 1.66; P= 0.001), minor adverse event (OR= 2.50; P< 0.001), discharged to a destination other than home (OR= 2.16, P< 0.001), hospital readmission (OR= 2.58; P< 0.001), and a long hospital length of stay (OR= 1.28, P= 0.001).Conclusion.For spine surgery patients, patient characteristics and perioperative outcomes were found to be significantly associated with the nonresponder bias for HCAHPS surveys. Although the potential resultant bias in HCAHPS scores cannot be directly determined, this must be considered in interpreting the results of such satisfaction surveys given that less than one-third of patients actually completed this survey in the study population.Level of Evidence: 3The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is a publicly reported patient satisfaction survey. Of 5517 spine surgeries at a single institution, only 27.3% of patients returned the HCAHPS survey. The rate of survey return was significantly associated with defined patient characteristics and perioperative outcomes.