Inpatient Rehabilitation Quality of Care From the Patient's Perspective

Effect of Data Collection Timing and Patient Characteristics

Anne Frances Deutsch*, Allen Walter Heinemann, Karon Frances Cook, Linda Foster, Ana Miskovic, Arielle Goldsmith, David Cella

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Objective: To compare, by collection time and patient characteristics, inpatient rehabilitation quality measure scores calculated using patient-reported data. Design: Cohort study of rehabilitation inpatients with neurologic conditions who reported their experience of care and pain status at discharge and 1month after discharge. Setting: Two inpatient rehabilitation facilities (IRFs). Participants: Patients with neurologic conditions (N=391). Interventions: Not applicable. Main Outcome Measures: We calculated 18 quality measure scores using participants’ responses to 55 experience of care and health status questions addressing communication, support and encouragement, care coordination, discharge information, goals, new medications, responsiveness of staff, cleanliness, quietness, pain management, care transitions, overall hospital rating, willingness to recommend, and pain. Results: Of the 391 participants reporting at discharge, 277 (71%) also reported postdischarge after multiple attempts by e-mail, mail, and telephone. Discharge experience of care quality scores ranged from 25% (responsiveness of hospital staff) to 75% (willingness to recommend hospital); corresponding postdischarge scores were 32% to 87%, respectively. Five of the 16 experience of care quality scores increased significantly between discharge and postdischarge. The percentage of participants reporting high pain levels at discharge did not change across time periods. Patients with less education, older age, higher motor and cognitive function, and those who were not Hispanic or black had more favorable quality measure scores. Conclusion: Patients’ experience of care responses tended to be more favorable after discharge compared to discharge, suggesting that survey timing is important. Responses were more favorable for patients with selected characteristics, suggesting the possible need for risk adjustment if patient-reported quality measure scores are compared across IRFs.

Original languageEnglish (US)
Pages (from-to)1032-1041
Number of pages10
JournalArchives of physical medicine and rehabilitation
Volume100
Issue number6
DOIs
StatePublished - Jun 1 2019

Fingerprint

Quality of Health Care
Inpatients
Rehabilitation
Postal Service
Pain
Nervous System
Risk Adjustment
Patient Transfer
Pain Management
Hispanic Americans
Telephone
Cognition
Health Status
Patient Care
Cohort Studies
Communication
Outcome Assessment (Health Care)
Education

Keywords

  • Health care
  • Nervous system diseases
  • Neurological rehabilitation
  • Pain measurement
  • Patient-centered care
  • Quality indicators
  • Rehabilitation
  • Rehabilitation centers

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

Cite this

@article{392f19d1c5904139bb74466d167c31c9,
title = "Inpatient Rehabilitation Quality of Care From the Patient's Perspective: Effect of Data Collection Timing and Patient Characteristics",
abstract = "Objective: To compare, by collection time and patient characteristics, inpatient rehabilitation quality measure scores calculated using patient-reported data. Design: Cohort study of rehabilitation inpatients with neurologic conditions who reported their experience of care and pain status at discharge and 1month after discharge. Setting: Two inpatient rehabilitation facilities (IRFs). Participants: Patients with neurologic conditions (N=391). Interventions: Not applicable. Main Outcome Measures: We calculated 18 quality measure scores using participants’ responses to 55 experience of care and health status questions addressing communication, support and encouragement, care coordination, discharge information, goals, new medications, responsiveness of staff, cleanliness, quietness, pain management, care transitions, overall hospital rating, willingness to recommend, and pain. Results: Of the 391 participants reporting at discharge, 277 (71{\%}) also reported postdischarge after multiple attempts by e-mail, mail, and telephone. Discharge experience of care quality scores ranged from 25{\%} (responsiveness of hospital staff) to 75{\%} (willingness to recommend hospital); corresponding postdischarge scores were 32{\%} to 87{\%}, respectively. Five of the 16 experience of care quality scores increased significantly between discharge and postdischarge. The percentage of participants reporting high pain levels at discharge did not change across time periods. Patients with less education, older age, higher motor and cognitive function, and those who were not Hispanic or black had more favorable quality measure scores. Conclusion: Patients’ experience of care responses tended to be more favorable after discharge compared to discharge, suggesting that survey timing is important. Responses were more favorable for patients with selected characteristics, suggesting the possible need for risk adjustment if patient-reported quality measure scores are compared across IRFs.",
keywords = "Health care, Nervous system diseases, Neurological rehabilitation, Pain measurement, Patient-centered care, Quality indicators, Rehabilitation, Rehabilitation centers",
author = "Deutsch, {Anne Frances} and Heinemann, {Allen Walter} and Cook, {Karon Frances} and Linda Foster and Ana Miskovic and Arielle Goldsmith and David Cella",
year = "2019",
month = "6",
day = "1",
doi = "10.1016/j.apmr.2018.10.019",
language = "English (US)",
volume = "100",
pages = "1032--1041",
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T1 - Inpatient Rehabilitation Quality of Care From the Patient's Perspective

T2 - Effect of Data Collection Timing and Patient Characteristics

AU - Deutsch, Anne Frances

AU - Heinemann, Allen Walter

AU - Cook, Karon Frances

AU - Foster, Linda

AU - Miskovic, Ana

AU - Goldsmith, Arielle

AU - Cella, David

PY - 2019/6/1

Y1 - 2019/6/1

N2 - Objective: To compare, by collection time and patient characteristics, inpatient rehabilitation quality measure scores calculated using patient-reported data. Design: Cohort study of rehabilitation inpatients with neurologic conditions who reported their experience of care and pain status at discharge and 1month after discharge. Setting: Two inpatient rehabilitation facilities (IRFs). Participants: Patients with neurologic conditions (N=391). Interventions: Not applicable. Main Outcome Measures: We calculated 18 quality measure scores using participants’ responses to 55 experience of care and health status questions addressing communication, support and encouragement, care coordination, discharge information, goals, new medications, responsiveness of staff, cleanliness, quietness, pain management, care transitions, overall hospital rating, willingness to recommend, and pain. Results: Of the 391 participants reporting at discharge, 277 (71%) also reported postdischarge after multiple attempts by e-mail, mail, and telephone. Discharge experience of care quality scores ranged from 25% (responsiveness of hospital staff) to 75% (willingness to recommend hospital); corresponding postdischarge scores were 32% to 87%, respectively. Five of the 16 experience of care quality scores increased significantly between discharge and postdischarge. The percentage of participants reporting high pain levels at discharge did not change across time periods. Patients with less education, older age, higher motor and cognitive function, and those who were not Hispanic or black had more favorable quality measure scores. Conclusion: Patients’ experience of care responses tended to be more favorable after discharge compared to discharge, suggesting that survey timing is important. Responses were more favorable for patients with selected characteristics, suggesting the possible need for risk adjustment if patient-reported quality measure scores are compared across IRFs.

AB - Objective: To compare, by collection time and patient characteristics, inpatient rehabilitation quality measure scores calculated using patient-reported data. Design: Cohort study of rehabilitation inpatients with neurologic conditions who reported their experience of care and pain status at discharge and 1month after discharge. Setting: Two inpatient rehabilitation facilities (IRFs). Participants: Patients with neurologic conditions (N=391). Interventions: Not applicable. Main Outcome Measures: We calculated 18 quality measure scores using participants’ responses to 55 experience of care and health status questions addressing communication, support and encouragement, care coordination, discharge information, goals, new medications, responsiveness of staff, cleanliness, quietness, pain management, care transitions, overall hospital rating, willingness to recommend, and pain. Results: Of the 391 participants reporting at discharge, 277 (71%) also reported postdischarge after multiple attempts by e-mail, mail, and telephone. Discharge experience of care quality scores ranged from 25% (responsiveness of hospital staff) to 75% (willingness to recommend hospital); corresponding postdischarge scores were 32% to 87%, respectively. Five of the 16 experience of care quality scores increased significantly between discharge and postdischarge. The percentage of participants reporting high pain levels at discharge did not change across time periods. Patients with less education, older age, higher motor and cognitive function, and those who were not Hispanic or black had more favorable quality measure scores. Conclusion: Patients’ experience of care responses tended to be more favorable after discharge compared to discharge, suggesting that survey timing is important. Responses were more favorable for patients with selected characteristics, suggesting the possible need for risk adjustment if patient-reported quality measure scores are compared across IRFs.

KW - Health care

KW - Nervous system diseases

KW - Neurological rehabilitation

KW - Pain measurement

KW - Patient-centered care

KW - Quality indicators

KW - Rehabilitation

KW - Rehabilitation centers

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