Inpatient Rehabilitation Quality of Care from the Patient's Perspective: Impact of Data Collection Timing and Patient Characteristics.

Inpatient Rehabilitation Quality of Care from the Patient's Perspective: Impact of Data Collection Timing and Patient Characteristics.

Arch Phys Med Rehabil. 2018 Nov 23;:

Authors: Deutsch A, Heinemann AW, Cook KF, Foster L, Miskovic A, Goldsmith A, Cella D

Abstract
OBJECTIVE: To compare, by collection time and patient characteristics, inpatient rehabilitation quality measure scores calculated using patient-reported data.
DESIGN: Cohort study of rehabilitation inpatients with neurologic conditions who reported their experience of care and pain status at discharge and one-month after discharge.
SETTING: Two inpatient rehabilitation facilities (IRFs) PARTICIPANTS: 391 patients with neurologic conditions INTERVENTIONS: Not Applicable MAIN OUTCOME MEASURES: We calculated 18 quality measure scores using participants' responses to 55 experience of care and health status questions addressing communication, support and encouragement, care coordination, discharge information, goals, new medications, responsiveness of staff, cleanliness, quietness, pain management, care transitions, overall hospital rating, willingness to recommend, and pain.
RESULTS: Of the 391 participants reporting at discharge, 277 (71%) also reported post-discharge after multiple attempts by email, mail, and telephone. Discharge experience of care quality scores ranged from 25% (responsiveness of hospital staff) to 75% (willingness to recommend hospital); corresponding post-discharge scores were 32% to 87%, respectively. Five of the 16 experience of care quality scores increased significantly between discharge and post-discharge. The percentage of participants reporting high pain levels at discharge did not change across time periods. Patients with less education, older age, higher motor and cognitive function, and those who were non-Hispanic Black had more favorable quality measure scores.
CONCLUSION: Patients' experience of care responses tended to be more favorable after discharge compared to discharge, suggesting that survey timing is important. Responses were more favorable for patients with selected characteristics, suggesting the possible need for risk adjustment if patient-reported quality measure scores are compared across IRFs.

PMID: 30476488 [PubMed - as supplied by publisher]

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