title: Accelerating Improvement and Narrowing Gaps: Trends in Patients' Experiences with Hospital Care Reflected in HCAHPS Public Reporting.
abstract: OBJECTIVE
  Measure HCAHPS improvement in hospitals participating in the second and fifth years of HCAHPS public reporting; determine whether change is greater for some hospital types.
  
  
  METHODS
  Surveys from 4,822,960 adult inpatients discharged July 2007-June 2008 or July 2010-June 2011 from 3,541 U.S. hospitals.
  
  
  METHODS
  Linear mixed-effect regression models with fixed effects for time, patient mix, and hospital characteristics (bedsize, ownership, Census division, teaching status, Critical Access status); random effects for hospitals and hospital-time interactions; fixed-effect interactions of hospital characteristics and patient characteristics (gender, health, education) with time predicted HCAHPS measures correcting for regression-to-the-mean biases.
  
  
  METHODS
  National probability sample of adult inpatients in any of four approved survey modes.
  
  
  RESULTS
  HCAHPS scores increased by 2.8 percentage points from 2008 to 2011 in the most positive response category. Among the middle 95 percent of hospitals, changes ranged from a 5.1 percent decrease to a 10.2 percent gain overall. The greatest improvement was in for-profit and larger (200 or more beds) hospitals.
  
  
  CONCLUSIONS
  Five years after HCAHPS public reporting began, meaningful improvement of patients' hospital care experiences continues, especially among initially low-scoring hospitals, reducing some gaps among hospitals.
authors: RAND Corporation, Santa Monica, CA.
authors: Marc N
authors: MN
authors: Elliott
authors: Surveys, Research & Analysis Division, Health Services Advisory Group, Phoenix, AZ.
authors: Christopher W
authors: CW
authors: Cohea
authors: Center for Beneficiary Choices Department, Centers for Medicare and Medicaid Services, Baltimore, MD.
authors: William G
authors: WG
authors: Lehrman
authors: Center for Beneficiary Choices Department, Centers for Medicare and Medicaid Services, Baltimore, MD.
authors: Elizabeth H
authors: EH
authors: Goldstein
authors: School of Public Health, Yale University, New Haven, CT.
authors: Paul D
authors: PD
authors: Cleary
authors: Surveys, Research & Analysis Division, Health Services Advisory Group, Phoenix, AZ.
authors: Laura A
authors: LA
authors: Giordano
authors: RAND Corporation, Santa Monica, CA.
authors: Megan K
authors: MK
authors: Beckett
authors: Harvard Medical School, Department of Health Care Policy, Boston, MA.
authors: Alan M
authors: AM
authors: Zaslavsky
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006302:Health Services Research; D006304:Health Status; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010067:Ownership / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012737:Sex Factors; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: HCAHPS; bedsize; for-profit; improvement