Relationship Between HCAHPS Scores and Survey Response Rate Is Linked to Hospital Size

Area of Science:

• Healthcare Quality
• Health Services Research
• Patient Experience Measurement

Background:

• Patient experience is a key healthcare quality indicator.
• The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey measures inpatient experience.
• HCAHPS scores may be influenced by survey response rates and hospital size.

Purpose of the Study:

• To investigate the association between HCAHPS survey response rates and HCAHPS scores.
• To determine if hospital size modifies the relationship between survey response rate and HCAHPS scores.

Main Methods:

• Utilized publicly reported HCAHPS data from Medicare's Hospital Compare.
• Employed Pearson correlation and linear regression models.
• Controlled for the number of staffed beds and analyzed hospitals in quartiles by size.

Main Results:

• A significant association was found between HCAHPS survey response rates and all examined HCAHPS domain scores.
• The magnitude of this association varied across HCAHPS domains depending on hospital size.
• Significant differences in the response rate-score relationship were observed between the smallest and largest hospitals for specific domains (discharge information, nurse communication, hospital quietness).

Conclusions:

• Survey response rate may be a direct or indirect driver of HCAHPS scores.
• The relationship between response rates and scores is moderated by hospital size.
• Further research is needed to understand the causal basis and implications for interpreting HCAHPS results.