A study suggests that safety-net hospitals performed more poorly than other types of hospitals on nearly every measure of patient experience, which could lead to financial consequences under the federal value-based purchasing program, according to a study published in Archives of Internal Medicine.
Under the value-based purchasing program, healthcare providers will be paid based on their performance on a range of metrics, including patient-reported experience from the Hospital Consumer Assessment of Healthcare Providers and Systems survey. For this study, researchers used the 2007 and 2010 HCAHPS survey results to determine patient-reported hospital experience at safety net hospitals and other types of hospitals. Ultimately, 3,096 U.S. hospitals were included, of which 769 were in the highest disproportionate share hospital index quartile and composed the safety net hospital group.
Results included the following:
• Safety-net hospitals performed worse than other hospital on nearly all measures of patient experience.
• The greatest differences were in overall hospital rating, for which patients at safety nets were less likely to rate the hospital a nine or 10 on a 10-point scale compared with patients at other hospitals.
• Safety net hospitals also performed worse on delivery of discharge information and physician communication.
• Safety net hospitals had 60 percent lower odds of meeting value-based purchasing metrics than other types of hospitals.
"Safety-net hospitals play a critical role in providing medical care to vulnerable populations, and ensuring that efforts to improve the quality of care at U.S. hospitals do not worsen existing disparities will be a key challenge to policy makers," researchers concluded.
Under the value-based purchasing program, healthcare providers will be paid based on their performance on a range of metrics, including patient-reported experience from the Hospital Consumer Assessment of Healthcare Providers and Systems survey. For this study, researchers used the 2007 and 2010 HCAHPS survey results to determine patient-reported hospital experience at safety net hospitals and other types of hospitals. Ultimately, 3,096 U.S. hospitals were included, of which 769 were in the highest disproportionate share hospital index quartile and composed the safety net hospital group.
Results included the following:
• Safety-net hospitals performed worse than other hospital on nearly all measures of patient experience.
• The greatest differences were in overall hospital rating, for which patients at safety nets were less likely to rate the hospital a nine or 10 on a 10-point scale compared with patients at other hospitals.
• Safety net hospitals also performed worse on delivery of discharge information and physician communication.
• Safety net hospitals had 60 percent lower odds of meeting value-based purchasing metrics than other types of hospitals.
"Safety-net hospitals play a critical role in providing medical care to vulnerable populations, and ensuring that efforts to improve the quality of care at U.S. hospitals do not worsen existing disparities will be a key challenge to policy makers," researchers concluded.
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