Priorities in hospital care across varying socioeconomic demographics

摘要

It is the intent of this study to aggregate subjective hospital performance measures and demographic metrics to identify trends in patient in-hospital experience ratings. Federal regulation requires hospitals to submit Hospital Consumer Assessments of Healthcare Providers and Systems (HCAHPS) results. The HCAHPS survey questionnaires are distributed to hospital patients between 48 hours and six weeks after their discharge with 27 questions regarding their experiences ranging from aspects of their visit such as nurse and doctor communication, care transition, and overall ratings of the hospital. Research in the field has demonstrated that demographic characteristics of the hospital district can affect an individual's perceived hospital experience. Factors such as education level and ethnicity have been shown to impact satisfaction ratings. How well a hospital performs on this survey can affect the level of federal funding and payer reimbursements a hospital receives. Therefore, for hospitals serving certain demographics, there is a potential to receive lower satisfaction results due to a bias given the patient population they largely serve. The goal of our work was to determine what components of care most affect patient satisfaction ratings, and whether these components vary across different demographics; this was done using random forest variable importance analysis. Our findings show that patient priorities, indeed differ across socioeconomic populations when determining the overall perceived value of care. Results of this analysis could allow hospitals to better cater to the priorities of their patients, thereby increasing their HCAHPS scores and resulting funding levels.