Does Patient Experience Predict 30-Day Readmission? A Patient-Level Analysis of HCAHPS Data

Area of Science:

• Healthcare quality research
• Patient experience measurement
• Hospital readmission analysis

Background:

• Hospital studies show an inverse link between patient experience and readmissions.
• Survey timing raises questions about whether patients respond before readmission or if readmission causes poor scores (reverse causation).

Purpose of the Study:

• Examine the relationship between patient readmissions and experience scores using patient-level data.
• Differentiate between patients responding to surveys before and after readmission.

Main Methods:

• Retrospective analysis of 10-year Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) data.
• Involved patients readmitted within 30 days and a control group of non-readmitted patients.
• Used multivariable logistic regression to analyze associations, controlling for patient factors.

Main Results:

• Only 15.8% of readmitted patients responded before readmission; their scores were similar to non-readmitted patients.
• Patients responding after readmission reported significantly lower satisfaction with physicians, staff responsiveness, pain control, discharge planning, and hospital environment.
• Key areas of dissatisfaction included physician communication, call button responsiveness, pain management, discharge instructions, noise levels, and cleanliness.

Conclusions:

• Findings suggest that being readmitted may cause poor patient experience, rather than poor experience predicting readmission.
• Highlights the potential for reverse causation in studies linking patient experience and hospital readmissions.