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01.12.2018 | Research article | Ausgabe 1/2018 Open Access

BMC Health Services Research 1/2018

Patients’ perceptions of interactions with hospital staff are associated with hospital readmissions: a national survey of 4535 hospitals

Zeitschrift:
BMC Health Services Research > Ausgabe 1/2018
Autoren:
Lianping Yang, Chaojie Liu, Cunrui Huang, Dana B. Mukamel
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12913-018-2848-9) contains supplementary material, which is available to authorized users.

Abstract

Background

Reducing 30-day hospital readmissions has become a focus of the current national payment policies. Medicare requires that hospitals collect and report patients’ experience with their care as a condition of payment. However, the extent to which patients’ experience with hospital care is related to hospital readmission is unknown.

Methods

We established multivariate regression models in which 30-day risk-adjusted readmission rates were the dependent variables and patients’ perceptions of the responsiveness of the hospital staff and communication (as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores) were the independent variables of interest. We selected six different clinical conditions for analyses, including acute myocardial infarction (AMI), chronic obstructive pulmonary disease (COPD), heart failure, hip/knee surgery, pneumonia, and stroke. Data included all acute care hospitals reporting in Hospital Compare in 2014.

Results

The number of hospitals with reported readmissions ranged from 2234 hospitals for AMI to 3758 hospitals for pneumonia. The average 30-day readmission rates ranged from 5.19% for knee/hip surgery to 22.7% for COPD. Patient experience of hospital-staff responsiveness as “top-box” ranged from 64% to 67% across the six clinical conditions, communication with nurses ranged from 77% to 79% and communication with doctors ranged from 80% to 81% (higher numbers are better). Our finding suggests that hospitals with better staff responsiveness were significantly more likely to have lower 30-day readmissions for all conditions. The effect size depended on the baseline readmission rates, with the largest effect on hospitals in the upper 75th quartile. A ten-percentage-point increase in staff responsiveness led to a 0.03–0.18 percentage point decrease in readmission rates. We found that neither communication with physicians nor communication with nurses was significantly associated with hospital readmissions.

Conclusions

Our findings suggest that elements of care related to staff responsiveness during patients’ stay may influence rehospitalization rates. Changes in staff responsiveness may offer an additional tool for hospitals to employ ongoing efforts to achieve reductions in readmissions, an important objective both financially and for patient health outcomes.
Zusatzmaterial
Additional file 1: Multivariable regressions - Predictors of 30-day readmission rates by clinical conditions. Details of the 18 multivariate regression models are presented in the supplementary materials. (DOCX 31 kb)
12913_2018_2848_MOESM1_ESM.docx
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