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Is Administrative Data a Quality Patient Satisfaction Measure?

Using administrative data as a patient satisfaction measure is less expensive than extensive patient surveying.

Hospitals should use administrative data as a patient satisfaction measure.

Source: Thinkstock

By Sara Heath

- Administrative data about healthcare facility characteristics offers some insight into patient satisfaction, helping to inform specific practice improvements, according to a study published in the American Journal of Managed Care.

Although many researchers have investigated how to improve patient satisfaction, very little work has been done about how different health system processes affect patient satisfaction scores, the research team said. Understanding this relationship could create a more effective way to raise patient satisfaction scores, they hypothesized.

The research team looked at patient satisfaction surveys and administrative data for 6,990 patients receiving mental healthcare from the VA in 2013.

The surveys showed overall patient satisfaction regarding care access and care experience. The administrative data reviewed patient experiences with program reach, psychosocial service access, program intensity (number of visits per patient), and treatment continuity.

Through a cross reference of both survey and administrative data, the researchers found that certain facility characteristics were associated with high satisfaction scores. Satisfaction with program reach and program intensity were tied to higher care access and care experience scores, for example.

READ MORE: How Hospitals Can Raise Patient Satisfaction, CAHPS Scores

Conversely, psychosocial service access was associated with neither access to care nor care experience. Although psychosocial service availability was not an indicator of patient satisfaction, organization leaders should still consider its value.

“If one took satisfaction as the only assessment of health system performance, they might conclude that psychosocial treatment access is not valuable. That is not the right interpretation,” the researchers argued. “Psychosocial treatment access is valuable for other reasons. For example, the subpopulation that does not respond adequately to medications may rely on this modality of care for improvement.”

Treatment continuity was likewise tied to both access and care experience satisfaction, the researchers found.

“It is likely that continuity of care was associated with greater satisfaction because those who were not satisfied with care tended to be lost to follow-up,” the team reported.

“Continuity of care may directly cause greater satisfaction (because patients want it), but the reverse may also be true: patients who are satisfied (for other reasons) may be more likely to return for subsequent appointments, increasing measured continuity of care,” the researchers added.

READ MORE: Patient Satisfaction Becomes Critical Concern for Hospitals

Overall program intensity was associated with neither care access nor experience satisfaction measures, but the researchers did not expect it to, they said. The program measure is not a meaningful indicator of any kind of patient satisfaction because intensity measures could increase simply by reducing the number of patients regardless of health status.

These findings are a considerable breakthrough for measuring patient satisfaction, the researchers argued.

Patient satisfaction surveying is a costly and time-consuming practice, requiring healthcare organizations to invest in a survey vendor. Organizations also must rely on patients to return completed surveys to glean adequate data.

Healthcare organizations that understand how different health system characteristics drive patient satisfaction can be successful for two fundamental reasons.

First, looking at administrative data to glean satisfaction insights can be more cost-effective. Health systems can save some of the cost and time burdens of patient satisfaction surveys because administrative data is a meaningful satisfaction measure.

READ MORE: Patient Satisfaction Data Transparency Aids Hospital Performance

Second, patient satisfaction itself cannot be changed without larger institutional change, the researchers asserted. A health system’s processes can change, which in turn can positively or negatively affect patient satisfaction scores. Thus, health systems should understand how different processes impact satisfaction.

Looking at program characteristics and administrative data is also valuable for data integrity and governance, the researchers pointed out. Certain program characteristics can inform the same set of satisfaction scores, ultimately serving as a check to confirm one another. This can mitigate any discrepancies that may arise from measures that are tied to financial incentives.

“Incentives can lead to loss of fidelity in the data underlying metrics, as behavior may be modified in direct response to the measure,” the research team explained. “If a metric tied to incentives starts to deviate considerably from another measuring the same thing in a different way, but it is not tied to incentives, that is a signal that the integrity of the underlying data may have been affected by the incentives.”

Given these findings, the researchers recommended healthcare leaders leverage administrative program information to monitor patient satisfaction scores. While healthcare organizations will still need to submit mandatory patient satisfaction scores (such as CAHPS survey data) to receive federal reimbursements, administrative data can help inform hospital leaders of which programs impact satisfaction.

From there, organization leaders can make specific changes to their processes that will lead to a better overall patient experience, the team concluded.