Which HCAHPS measures fell most during pandemic

HCAHPS measures assessing hospital staff's responsiveness and hospital cleanliness fell the most during the pandemic as hospitals grappled with severe staffing shortages, according to a study published Aug. 25 in JAMA Health Forum.

The study, conducted by RAND Corp., analyzed HCAHPS data covering 3.9 million discharges from 3,381 hospitals between 2018 and 2021. 

HCAHPS summary scores — the average of 10 HCAHPS measures — were 1.2 percentage points lower in the second quarter of 2020 compared to 2018-19 data. This gap grew to 3.6 percentage points by the fourth quarter of 2021. 

The HCAHPS measures that fell the most during the study period were staff responsiveness (down 5.6 percentage points) and hospital cleanliness (down 4.9 percentage points). Discharge information and quietness measures were least affected during COVID-19.

Hospitals with higher staffing levels maintained better patient experience ratings for a longer duration during the pandemic, though HCAHPS performance eventually fell nationwide. The decreases were largest for hospitals that were lower-performing and had lower staffing levels prior to the pandemic.  

"This unprecedented decline in patient experience was seen in every region of the United States, with relatively little regional variation," lead author Marc Elliott, PhD, a senior principal researcher at RAND, said in a Aug. 25 news release. "Hospitals with higher staffing levels and better overall pre-pandemic quality were more resilient and slower to see their decline. But eventually even their patients also reported worse experiences."

 View the full study here.

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