Patient experience surveys should start probing discrimination, researchers say

HCAHPS surveys have been around for more than 15 years, yet they still don't poll patients on whether they've experienced discrimination or recieved culturally competent care, Kaiser Health News reported Sept. 8. 

Researchers told the news outlet not probing this kind of information is a major oversight, citing studies that indicate patients want to be asked about discrimination and trust. Absent explicit questions about these issues, HCAHPS data as it stands now would not "tell you whether or not you have a racist system," Jose Figueroa, MD, an assistant professor of health policy and management at Cambridge, Mass.-based Harvard University, told the news outlet. 

While HCAHPS does ask respondents about their race, ethnicity and language, it's not part of the data CMS posts publicly on its website for patients to see. Comparisons of how patients from different backgrounds responded is also unavailable. 

Press Ganey, which administers surveys for many hospitals, is exploring an initiative to use artificial intelligence to go beyond multiple choice responses and probe patients' narrative comments for signs of inequities. 

"It's still pretty early days," Tejal Gandhi, MD, chief safety and transformation officer at Press Ganey, told KHN. "With what's gone on with the pandemic, and with social justice issues, and all those things over the last couple of years, there's just been a much greater interest in this topic area." 

CMS is now working to make changes and incorporate more questions centered on dscrimination. KHN reported the agency is testing a question for a subset of patients over the age of 65 that asks whether anyone during their healthcare visit treated them "in an unfair or insensitive way" because of characteristics such as race, ethnicity or sexual orientation. 

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