TY - JOUR
T1 - Are caregivers who respond to the child HCAHPS survey reflective of all hospitalized pediatric patients?
AU - Lee, Brian
AU - Hollenbeck-Pringle, Danielle
AU - Goldman, Victoria
AU - Biondi, Eric
AU - Alverson, Brian
N1 - Publisher Copyright:
Copyright © 2019 by the American Academy of Pediatrics
PY - 2019/3
Y1 - 2019/3
N2 - OBJECTIVES: The Child Hospital Consumer Assessment of Healthcare Providers and Systems (C-HCAHPS) survey was developed to measure satisfaction levels of pediatric inpatients’ caregivers. Studies in adults have revealed that certain demographic groups (people of color or who are multiracial and people with public insurance) respond to surveys at decreased rates, contributing to nonresponse bias. Our primary goal was to determine if results from the C-HCAHPS survey accurately reflect the intended population or reveal evidence of nonresponse bias. Our secondary goal was to examine whether demographic or clinical factors were associated with increased satisfaction levels. METHODS: This was a retrospective cohort study of responses (n 5 421) to the C-HCAHPS survey of patients admitted to a tertiary-care pediatric hospital between March 2016 and March 2017. Respondent demographic information was compared with that of all hospital admissions over the same time frame. Satisfaction was defined as “top-box” scores for questions on overall rating and willingness to recommend the hospital. RESULTS: Caregivers returning surveys were more likely to be white, non-Hispanic, and privately insured (P, .001). Caregivers with the shortest emergency department wait times were more likely to assign top-box scores for global rating (P 5 .025). We found no differences in satisfaction between race and/or ethnicity, length of stay, insurance payer, or total cost. CONCLUSIONS: Caregivers who identified with underrepresented minority groups and those without private insurance were less likely to return surveys. Among the surveys received, short emergency department wait time and older age were the only factors measured that were associated with higher satisfaction. Efforts to increase patient satisfaction on the basis of satisfaction scores may exacerbate existing disparities in health care.
AB - OBJECTIVES: The Child Hospital Consumer Assessment of Healthcare Providers and Systems (C-HCAHPS) survey was developed to measure satisfaction levels of pediatric inpatients’ caregivers. Studies in adults have revealed that certain demographic groups (people of color or who are multiracial and people with public insurance) respond to surveys at decreased rates, contributing to nonresponse bias. Our primary goal was to determine if results from the C-HCAHPS survey accurately reflect the intended population or reveal evidence of nonresponse bias. Our secondary goal was to examine whether demographic or clinical factors were associated with increased satisfaction levels. METHODS: This was a retrospective cohort study of responses (n 5 421) to the C-HCAHPS survey of patients admitted to a tertiary-care pediatric hospital between March 2016 and March 2017. Respondent demographic information was compared with that of all hospital admissions over the same time frame. Satisfaction was defined as “top-box” scores for questions on overall rating and willingness to recommend the hospital. RESULTS: Caregivers returning surveys were more likely to be white, non-Hispanic, and privately insured (P, .001). Caregivers with the shortest emergency department wait times were more likely to assign top-box scores for global rating (P 5 .025). We found no differences in satisfaction between race and/or ethnicity, length of stay, insurance payer, or total cost. CONCLUSIONS: Caregivers who identified with underrepresented minority groups and those without private insurance were less likely to return surveys. Among the surveys received, short emergency department wait time and older age were the only factors measured that were associated with higher satisfaction. Efforts to increase patient satisfaction on the basis of satisfaction scores may exacerbate existing disparities in health care.
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U2 - 10.1542/hpeds.2018-0139
DO - 10.1542/hpeds.2018-0139
M3 - Article
C2 - 30709907
AN - SCOPUS:85076270485
SN - 2154-1663
VL - 9
SP - 162
EP - 169
JO - Hospital Pediatrics
JF - Hospital Pediatrics
IS - 3
ER -