TY - JOUR
T1 - Association of Patient-Reported Readiness for Discharge and Hospital Consumer Assessment of Health Care Providers and Systems Patient Satisfaction Scores
T2 - A Retrospective Analysis
AU - Schmocker, Ryan K.
AU - Holden, Sara E.
AU - Vang, Xia
AU - Leverson, Glen E.
AU - Cherney Stafford, Linda M.
AU - Winslow, Emily R.
N1 - Publisher Copyright:
© 2015 American College of Surgeons.
PY - 2015
Y1 - 2015
N2 - Background Patient-reported outcomes (PRO) have been increasingly emphasized, however, determining clinically valuable PRO has been problematic and investigation limited. This study examines the association of readiness for discharge, which has been described previously, with patient satisfaction and readmission. Study Design Data from adult patients admitted to our institution from 2009 to 2012 who completed both the Hospital Consumer Assessment of Healthcare Providers and Systems and the Press Ganey surveys post discharge were extracted from an existing database of patients (composed of 220 patients admitted for small bowel obstruction and 98 patients with hospital stays ≥21 days). Using the survey question, "Did you feel ready for discharge?" (RFD), 2 groups were constructed, those RFD and those with lesser degrees of readiness (ie, less ready for discharge [LRFD]) using topbox methodology. Outcomes, readmission rates, and satisfaction were compared between RFD and LRFD groups. Results Three hundred and eighteen patients met the inclusion criteria; 45% were female and 94% were Caucasian. Median age was 62.3 years (interquartile range 52.5 to 70.8 year). Median length of stay was 10 days (interquartile range 6.0 to 24.0 days) and 69.2% were admitted with small bowel obstruction. The 30-day readmission rate was 14.3% and 55% indicated they were RFD. Those RFD and LRFD had similar demographics, comorbidity scores, and rates of surgery. Those RFD had higher overall hospital satisfaction (87.3% RFD vs 62.4% LRFD; p < 0.001), higher physician communication scores (median 3.0 RFD vs 2.0 LRFD; p < 0.001), and higher nursing communication scores (median 3.0 RFD vs 2.0 LRFD, p < 0.001). Readmission rates were similar between the groups (11.4% RFD vs 18.2% LRFD; p = 0.09). Conclusions Readiness for discharge appears to be a clinically useful patient-reported metric, as those RFD have higher satisfaction with the hospital and physicians. Prospective investigation into variables affecting patient satisfaction in those LRFD is needed.
AB - Background Patient-reported outcomes (PRO) have been increasingly emphasized, however, determining clinically valuable PRO has been problematic and investigation limited. This study examines the association of readiness for discharge, which has been described previously, with patient satisfaction and readmission. Study Design Data from adult patients admitted to our institution from 2009 to 2012 who completed both the Hospital Consumer Assessment of Healthcare Providers and Systems and the Press Ganey surveys post discharge were extracted from an existing database of patients (composed of 220 patients admitted for small bowel obstruction and 98 patients with hospital stays ≥21 days). Using the survey question, "Did you feel ready for discharge?" (RFD), 2 groups were constructed, those RFD and those with lesser degrees of readiness (ie, less ready for discharge [LRFD]) using topbox methodology. Outcomes, readmission rates, and satisfaction were compared between RFD and LRFD groups. Results Three hundred and eighteen patients met the inclusion criteria; 45% were female and 94% were Caucasian. Median age was 62.3 years (interquartile range 52.5 to 70.8 year). Median length of stay was 10 days (interquartile range 6.0 to 24.0 days) and 69.2% were admitted with small bowel obstruction. The 30-day readmission rate was 14.3% and 55% indicated they were RFD. Those RFD and LRFD had similar demographics, comorbidity scores, and rates of surgery. Those RFD had higher overall hospital satisfaction (87.3% RFD vs 62.4% LRFD; p < 0.001), higher physician communication scores (median 3.0 RFD vs 2.0 LRFD; p < 0.001), and higher nursing communication scores (median 3.0 RFD vs 2.0 LRFD, p < 0.001). Readmission rates were similar between the groups (11.4% RFD vs 18.2% LRFD; p = 0.09). Conclusions Readiness for discharge appears to be a clinically useful patient-reported metric, as those RFD have higher satisfaction with the hospital and physicians. Prospective investigation into variables affecting patient satisfaction in those LRFD is needed.
UR - http://www.scopus.com/inward/record.url?scp=84951749505&partnerID=8YFLogxK
U2 - 10.1016/j.jamcollsurg.2015.09.009
DO - 10.1016/j.jamcollsurg.2015.09.009
M3 - Article
C2 - 26474513
AN - SCOPUS:84951749505
SN - 1072-7515
VL - 221
SP - 1073-1082.e3
JO - Journal of the American College of Surgeons
JF - Journal of the American College of Surgeons
IS - 6
ER -