Assessing consumer perceptions of inpatient psychiatric treatment: the perceptions of care survey.
BACKGROUND
Consumer perceptions of behavioral health care are widely recognized as important quality indicators. This article reports the development and use of the Perceptions of Care (PoC) survey, a standardized public domain measure of consumer perceptions of the quality of inpatient mental health or substance abuse care. The goals were to develop a low-cost, low-burden survey that would address important quality domains, allow for interprogram comparisons and national benchmarks, be useful for quality improvement purposes, and meet accreditation and payer requirements.


METHODS
The sample was composed of 6,972 patients treated in 14 inpatient behavioral health or substance abuse treatment programs. The PoC survey was given to patients by program staff in the 24-hour period before discharge.


RESULTS
Aggregate reports and ratings of care identified areas that are highly evaluated by consumers, as well as areas that provide opportunities for quality improvement. Factor analysis identified four domains of care, and a 100-point score was developed for each domain. Regression analyses identified significant predictors of perceptions of care for use in computing risk-adjusted scores. Unadjusted and adjusted scores were presented to demonstrate the impact of risk adjustment on quality of care scores and relative ranking of programs. Examples were given of how programs used survey results to improve the quality of care.


CONCLUSIONS
Results demonstrated that the PoC survey is sensitive to detecting differences among inpatient behavioral health programs and can be useful in guiding quality improvement efforts. However, risk adjustment is important for appropriate interpretation of results.
Eisen
Susan V
SV
Center for Health Quality, Outcomes & Economic Research, EN Rogers Memorial Veterans Hospital, 200 Springs Road (152), Bedford, MA 01730, USA. seisen@bu.edu
Wilcox
Marsha
M
Idiculla
Thomas
T
Speredelozzi
Alexander
A
Dickey
Barbara
B
D001524:Behavioral Medicine / Q000592:standards; D019985:Benchmarking; D005163:Factor Analysis, Statistical; D019538:Health Care Surveys; D006801:Humans; D001523:Mental Disorders / Q000628:therapy; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011567:Psychiatric Department, Hospital / Q000592:standards*; D019984:Quality Indicators, Health Care; D012044:Regression Analysis; D020379:Risk Adjustment; D016320:Substance Abuse Treatment Centers / Q000592:standards*; D019966:Substance-Related Disorders / Q000628:therapy; D017749:Total Quality Management; D014481:United States