Ethnicity and Language Differences in Patient Experience: an Analysis of the HCAHPS Survey

Donaldson, Candice D.; Bharadwaj, Archana; Giafaglione, Bradley; Patton, Pat; Fortier, Michelle A.; Kain, Zeev N.

doi:10.1007/s40615-021-01029-0

Cited by 4 publications

(1 citation statement)

References 34 publications

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“…This top-box methodology is the standard approach for assessing patient satisfaction in US hospitals that use the Hospital Consumer Assessment of Healthcare Providers and Systems. [23][24][25][26][27][28]…”

Section: Outcomementioning

confidence: 99%

A Multivariable Model of Parent Satisfaction, Pain, and Opioid Administration in a Pediatric Emergency Department

Donaldson

Heyming

Ehwerhemuepha

et al. 2021

WestJEM

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Introduction: Children and adolescents are not impervious to the unprecedented epidemic of opioid misuse in the United States. In 2016 more than 88,000 adolescents between the ages of 12–17 reported misusing opioid medication, and evidence suggests that there has been a rise in opioid-related mortality for pediatric patients. A major source of prescribed opioids for the treatment of pain is the emergency department (ED). The current study sought to assess the complex relationship between opioid administration, pain severity, and parent satisfaction with children’s care in a pediatric ED. Methods: We examined data from a tertiary pediatric care facility. A health survey questionnaire was administered after ED discharge to capture the outcome of parental likelihood of providing a positive facility rating. We abstracted patient demographic, clinical, and top diagnostic information using electronic health records. Data were merged and multivariable models were constructed. Results: We collected data from 15,895 pediatric patients between the ages of 0–17 years (mean = 6.69; standard deviation = 5.19) and their parents. Approximately 786 (4.94%) patients were administered an opioid; 8212 (51.70%) were administered a non-opioid analgesic; and 3966 (24.95%) expressed clinically significant pain (pain score >/= 4). Results of a multivariable regression analysis from these pediatric patients revealed a three-way interaction of age, pain severity, and opioid administration (odds ratio 1.022, 95% confidence interval, 1.006, 1.038, P = 0.007). Our findings suggest that opioid administration negatively impacted parent satisfaction of older adolescent patients in milder pain who were administered an opioid analgesic, but positively influenced the satisfaction scores of parents of younger children who were administered opioids. When pain levels were severe, the relationship between age and patient experience was not statistically significant. Conclusion: This investigation highlights the complexity of the relationship between opioid administration, pain severity, and satisfaction, and suggests that the impact of opioid administration on parent satisfaction is a function of the age of the child.

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Section: Outcomementioning

confidence: 99%

A Multivariable Model of Parent Satisfaction, Pain, and Opioid Administration in a Pediatric Emergency Department

Donaldson

Heyming

Ehwerhemuepha

et al. 2021

WestJEM

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Informal carers' experiences with their children's care during hospitalization in Italy: Child HCAHPS results from RN4CAST@IT-Ped cross-sectional study

Dasso,

Catania,

Zanini

et al. 2024

Journal of Pediatric Nursing

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Leaving Against Medical Advice From Children’s Hospitals

Campbell,

Tolliver,

et al. 2024

Pediatrics

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BACKGROUND: Leaving the hospital against medical advice (AMA) reflects a breakdown in the family-clinician relationship and creates ethical dilemmas in inpatient pediatric care. There are no national data on frequency or characteristics of leaving AMA from US children’s hospitals. METHODS: We performed a retrospective cohort study of hospital discharges for children under 18 years old from January 1, 2018 to December 31, 2022 in 43 children’s hospitals in the Pediatric Health Information System (PHIS) database. The primary outcome was leaving AMA. Exposures were demographic, geographic, and clinical characteristics. We used multivariable mixed effects logistic regression models to assess independent factors associated with leaving AMA and all-cause 14-day hospital readmission. RESULTS: Among 3 672 243 included inpatient encounters, 2972 (0.08%) ended in leaving AMA. Compared with non-Hispanic white patients, non-Hispanic Black patients had higher odds of leaving AMA (adjusted odds ratio [aOR] 1.31 [95% confidence interval (CI) 1.19–1.44]), whereas Hispanic patients (aOR 0.66 [95% CI 0.59–0.75]) had lower odds of leaving AMA. Hospitalizations for patients with noncommercial insurance were more likely to end in leaving AMA. Leaving AMA was associated with increased odds of 14-day inpatient readmission (aOR 1.41 [95% CI 1.24–1.61]) compared with patients who did not leave AMA. There was substantial interhospital variability in standardized rates of leaving AMA (range 0.18–2.14 discharges per 1000 inpatient encounters). CONCLUSIONS: Approximately 1 in 1235 inpatient encounters ended in leaving AMA. Non-Hispanic Black patients had increased odds of leaving AMA. Leaving AMA was associated with increased odds of 14-day readmission.

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Ethnicity and Language Differences in Patient Experience: an Analysis of the HCAHPS Survey

Cited by 4 publications

References 34 publications

A Multivariable Model of Parent Satisfaction, Pain, and Opioid Administration in a Pediatric Emergency Department

A Multivariable Model of Parent Satisfaction, Pain, and Opioid Administration in a Pediatric Emergency Department

Informal carers' experiences with their children's care during hospitalization in Italy: Child HCAHPS results from RN4CAST@IT-Ped cross-sectional study

Leaving Against Medical Advice From Children’s Hospitals

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