Inpatient Rehabilitation Quality of Care From the Patient’s Perspective: Effect of Data Collection Timing and Patient Characteristics

Publication date: June 2019

Source: Archives of Physical Medicine and Rehabilitation, Volume 100, Issue 6

Author(s): Anne Deutsch, Allen W. Heinemann, Karon F. Cook, Linda Foster, Ana Miskovic, Arielle Goldsmith, David Cella

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.

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