Mona Al-Amin1, Melody K Schiaffino, Sinyoung Park, Jeffrey Harman. 1. Mona Al-Amin, PhD, interim chair and associate professor, Healthcare Administration, Suffolk University, Boston, Massachusetts; Melody K. Schiaffino, PhD, assistant professor, Division of Health Management and Policy, San Diego State University, California; Sinyoung Park, PhD, assistant professor, Department of Health Administration, University of North Florida, Jacksonville; and Jeffrey Harman, PhD, professor, Department of Behavioral Sciences & Social Medicine, College of Medicine, Florida State University, Tallahassee.
Abstract
EXECUTIVE SUMMARY: This study examines hospital characteristics associated with sustained superior performance on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) measures. We classified hospitals as sustainers if they remained in the top 25th percentile of overall patient ratings of inpatient experience from 2009 through 2013. We classified hospital characteristics as modifiable or unmodifiable. Modifiable characteristics are operational measures that hospitals can change to improve performance; these characteristics include registered nurse (RN) staffing levels, presence of hospitalists, and level of physician integration. Unmodifiable characteristics are core structural dimensions, such as hospital size and teaching status, that require substantial investment to change, as well as market-level factors such as competition and unemployment rates. Using logistic regression analysis, we found that RN staffing levels, Medicare share of inpatient days, teaching status, and market competition were significant predictors of the likelihood that a given hospital sustained high levels of patient ratings over time (i.e., the likelihood of a hospital being classified as a sustainer). Hospitals with a higher ratio of inpatient days to RN staffing and higher Medicare share of inpatient days had lower odds of being classified as sustainers.
EXECUTIVE SUMMARY: This study examines hospital characteristics associated with sustained superior performance on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) measures. We classified hospitals as sustainers if they remained in the top 25th percentile of overall patient ratings of inpatient experience from 2009 through 2013. We classified hospital characteristics as modifiable or unmodifiable. Modifiable characteristics are operational measures that hospitals can change to improve performance; these characteristics include registered nurse (RN) staffing levels, presence of hospitalists, and level of physician integration. Unmodifiable characteristics are core structural dimensions, such as hospital size and teaching status, that require substantial investment to change, as well as market-level factors such as competition and unemployment rates. Using logistic regression analysis, we found that RN staffing levels, Medicare share of inpatient days, teaching status, and market competition were significant predictors of the likelihood that a given hospital sustained high levels of patient ratings over time (i.e., the likelihood of a hospital being classified as a sustainer). Hospitals with a higher ratio of inpatient days to RN staffing and higher Medicare share of inpatient days had lower odds of being classified as sustainers.
Authors: Kelly J Thomas Craig; Mollie M McKillop; Hu T Huang; Judy George; Ekta S Punwani; Kyu B Rhee Journal: BMC Health Serv Res Date: 2020-07-10 Impact factor: 2.655