Dataset Information

Hospital uncompensated care and patient experience: An instrumental variable approach.

ABSTRACT:

Objective

Examine the endogenous relationship between uncompensated care and hospital patient experience scores.

Data sources/study setting

The Hospital Consumer Assessment of Healthcare Providers and Systems Survey, CMS Healthcare Cost Report Information System, and the US Census Bureau.

Study design

The exogenous change in uncompensated care caused by the 2014 Medicaid expansion was exploited to measure the effect of uncompensated care on patient experience scores using a 2SLS regression with instrumental variables approach.

Data collection/extraction methods

U.S. general, short-term hospitals whose DSH status remained constant and had nonmissing data for 2011-2015, which totaled 969 unique hospitals per year.

Principal findings

The effect of uncompensated care on patient experience was in the predicted direction, with three of the 10 measures being statistically significant. A one percentage point increase in uncompensated care costs resulted in a 0.25-0.50 percentage point decrease in select patient experience scores.

Conclusions

Results indicate a weak relationship between uncompensated care and patient experience scores, as a reduction in uncompensated care is related to quality improvement for some hospitals. These findings have implications for hospitals as they navigate changing reimbursement structures and policy makers considering changes to Obama-era health care reforms.

SUBMITTER: Camilleri S

PROVIDER: S-EPMC6505421 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Hospital uncompensated care and patient experience: An instrumental variable approach.

Camilleri Susan S Diebold Jeffrey J

Health services research 20190109 3

<h4>Objective</h4>Examine the endogenous relationship between uncompensated care and hospital patient experience scores.<h4>Data sources/study setting</h4>The Hospital Consumer Assessment of Healthcare Providers and Systems Survey, CMS Healthcare Cost Report Information System, and the US Census Bureau.<h4>Study design</h4>The exogenous change in uncompensated care caused by the 2014 Medicaid expansion was exploited to measure the effect of uncompensated care on patient experience scores using a ...[more]

PMID: 30628070

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Project description:OBJECTIVES:China launched the National Healthcare Improvement Initiative (NHII) in 2015 to improve patient experiences in healthcare. This study aimed to generate evidence of hospital care quality from the patients' perspective. DESIGN:This nationwide cross-sectional study interviewed participants from 31 provinces, municipalities and autonomous regions across China. SETTING:A total of 117 tertiary hospitals in mainland China. PARTICIPANTS:48 422 responses from outpatients and 35 957 responses from inpatients were included in this study. PRIMARY OUTCOME MEASURE:The scores of six predefined domains in the Chinese Patient Experience Questionnaire, five of which were designed to reflect specific dimensions of care, and one of which indicated the overall rating. RESULTS:More than 80% of the respondents viewed their care experiences as positive. The NHII seems to have had a positive impact, as indicated by the steady, although unremarkable, increase in the patient experience scores over the 2016-2018 period. The Chinese patients generally reported a positive experience with the clinical aspects of care, but reported a less positive experience with the environmental, interpersonal and social services aspects of care. The institutional factors, including region and type of hospital, and personal factors, such as gender, age, education and occupation, were factors affecting the patient experience in China. Humanistic care was the aspect of care with the greatest association with the overall patient experience rating in both the outpatient and inpatient settings. CONCLUSIONS:The national survey indicated an overall positive patient perspective of care in China. Older age, higher education level and formal employment status were found to be correlated with positive care experiences, as were higher levels of economic development of the region, a more generous insurance benefits package and a higher degree of coordinated care. The interpersonal-related initiatives had substantial roles in the improvement of the patient experience. In the regions where farmers and users of traditional Chinese medicine services constitute a greater proportion of the population, improvement of patient experiences for these groups deserves special policy attention.

Dataset Information

Hospital uncompensated care and patient experience: An instrumental variable approach.

Objective

Data sources/study setting

Study design

Data collection/extraction methods

Principal findings

Conclusions

Publications

Hospital uncompensated care and patient experience: An instrumental variable approach.

Similar Datasets

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