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      Patient satisfaction and quality of surgical care in US hospitals.

      1 , ,
      Annals of surgery
      Ovid Technologies (Wolters Kluwer Health)

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          Abstract

          The relationship between patient satisfaction and surgical quality is unclear for US hospitals. Using national data, we examined if hospitals with high patient satisfaction have lower levels of performance on accepted measures of the quality and efficiency of surgical care.

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          Most cited references20

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          The patient experience and health outcomes.

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            Variation in surgical-readmission rates and quality of hospital care.

            Reducing hospital-readmission rates is a clinical and policy priority, but little is known about variation in rates of readmission after major surgery and whether these rates at a given hospital are related to other markers of the quality of surgical care. Using national Medicare data, we calculated 30-day readmission rates after hospitalization for coronary-artery bypass grafting, pulmonary lobectomy, endovascular repair of abdominal aortic aneurysm, open repair of abdominal aortic aneurysm, colectomy, and hip replacement. We used bivariate and multivariate techniques to assess the relationships between readmission rates and other measures of surgical quality, including adherence to surgical process measures, procedure volume, and mortality. For the six index procedures, there were 479,471 discharges from 3004 hospitals. The median risk-adjusted composite readmission rate at 30 days was 13.1% (interquartile range, 9.9 to 17.1). In a multivariate model adjusting for hospital characteristics, we found that hospitals in the highest quartile for surgical volume had a significantly lower composite readmission rate than hospitals in the lowest quartile (12.7% vs. 16.8%, P<0.001), and hospitals with the lowest surgical mortality rates had a significantly lower readmission rate than hospitals with the highest mortality rates (13.3% vs. 14.2%, P<0.001). High adherence to reported surgical process measures was only marginally associated with reduced readmission rates (highest quartile vs. lowest quartile, 13.1% vs. 13.6%; P=0.02). Patterns were similar when each of the six major surgical procedures was examined individually. Nearly one in seven patients hospitalized for a major surgical procedure is readmitted to the hospital within 30 days after discharge. Hospitals with high surgical volume and low surgical mortality have lower rates of surgical readmission than other hospitals.
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              Development, implementation, and public reporting of the HCAHPS survey.

              The authors describe the history and development of the CAHPS Hospital Survey (also known as HCAHPS) and its associated protocols. The randomized mode experiment, vendor training, and "dry runs" that set the stage for initial public reporting are described. The rapid linkage of HCAHPS data to annual payment updates ("pay for reporting") is noted, which in turn led to the participation of approximately 3,900 general acute care hospitals (about 90% of all such United States hospitals). The authors highlight the opportunities afforded by this publicly reported data on hospital inpatients' experiences and perceptions of care. These data, reported on www.hospitalcompare.hhs. gov, facilitate the national comparison of patients' perspectives of hospital care and can be used alone or in conjunction with other clinical and outcome measures. Potential benefits include increased transparency, improved consumer decision making, and increased incentives for the delivery of high-quality health care.
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                Author and article information

                Journal
                Ann. Surg.
                Annals of surgery
                Ovid Technologies (Wolters Kluwer Health)
                1528-1140
                0003-4932
                Jan 2015
                : 261
                : 1
                Affiliations
                [1 ] Department of *Health Policy and Management, Harvard School of Public Health, Boston, MA †Department of Surgery, Brigham and Women's Hospital, Boston, MA ‡Department of Biostatistics, Harvard School of Public Health, Boston, MA §Department of Medicine, Division of General Internal Medicine, Brigham and Women's Hospital, Boston, MA; and ¶VA Boston Healthcare System, Boston, MA.
                Article
                NIHMS604046
                10.1097/SLA.0000000000000765
                4248016
                24887985
                e538ab5b-a5f0-4223-b5df-8ea7054f5d38
                History

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