在HCAHPS调查得分的趋势,2008-2019:质量改善的前景
Megan K Beckett1, Denise D Quigley1, Christopher W Cohea2
1RAND Corporation, Santa Monica, CA.
Medical care
|May 10, 2024
概括
从2008年到2013年,医院患者体验得分 (HCAHPS) 显著改善,特别是在表现较差的医院. 随后的改进在基于价值的购买和星级评级的引入后放缓.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 改善医疗保健质量 改善医疗保健质量
- 患者体验测量 患者体验测量
背景情况:
- 医院对医疗保健提供者和系统的消费者评估 (HCAHPS) 于2008年实施,并向公众报告,随后于2012年纳入医院基于价值的采购计划 (HVBP) 和2015年医院星级评级.
- 这些举措旨在增强患者体验,并推动美国医院的质量改善.
研究的目的:
- 从2008年到2019年,在COVID-19大流行之前,分析HCAHPS得分的趋势.
- 在HCAHPS实施和报告的不同阶段描述这些趋势.
主要方法:
- 分析了2008年至2019年间来自美国3909家医院的HCAHPS数据.
- 分析了整体趋势和不同阶段的趋势:初次公开报告 (2008-2013),HVBP (2013-2015) 和星级评级 (2015-2019).
- 考虑了医院的特点,包括HCAHPS分数,所有权,规模,教学地位和城市/农村位置.
主要成果:
- 从2007年到2019年,HCAHPS总结得分 (HCAHPS-SS) 的平均值提高了5.2个百分点 (pp).
- 改善率在最初的公开报告阶段是最高的 (0.8个百分比/年),在随后的阶段放缓.
- 在整体医院评级,出院信息和护士沟通方面,改善最为显著. 最低十进制医院在所有指标上都表现出更大的改善.
结论:
- 从2008年到2013年,HCAHPS的措施得到了快速改善,特别是在表现较差的医院,减少了绩效差异.
- 最初的快速增长可能归因于广泛的质量改进努力.
- 在HVBP和星级评级引入后,后续改善速度较慢,这表明在表现较好的医院中,转向更有针对性的质量改善.
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