Hemodialysis Patient Experience and the In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH CAHPS) Survey: An In-depth Evaluation of Survey Response and Clinical Outcomes
Dad, Taimur.
2018
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Abstract: Background
The In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH
CAHPS) survey is the only patient-reported outcome measure currently used to evaluate
patient experience across all in-center hemodialysis facilities in the US. Since
mandatory implementation in 2014, response rates have been very low while the financial
and public reporting importance ... read moreof this measure has been increasing. Despite this, there
has been no real-world evaluation of non-response or factors associated with better
reported experience. Methods All Dialysis Clinic Inc. (DCI) patients nationally who met
eligibility for the survey were included. Patient-level demographic, clinical and
treatment related characteristics were obtained from DCI's electronic medical record.
These data were merged with patient-level survey response status and survey scores.
Multivariable logistic regression was performed to evaluate characteristics associated
with non-response. Cox proportional hazards models were used to evaluate survey response
status and long-term clinical outcomes. Lastly, multivariable logistic regression was
performed to evaluate characteristics associated with higher experience scores within
six domains. Results Non-responders to the ICH CAHPS survey were generally younger,
non-white, male sex, more socio-economically disadvantaged, sicker, and less adherent to
dialysis treatments. Survey responders had a lower risk of dying or being hospitalized
and had a higher likelihood of receiving a kidney transplant. Older age and telephone
administration of the survey were consistently associated with higher experience scores
while other characteristics varied depending on the ICH CAHPS patient experience domain
being evaluated. Conclusions Current ICH CAHPS survey results are generated from a
select group of patients with more favorable long-term clinical outcomes and therefore
lack generalizability. Certain demographic, clinical and treatment related
characteristics are associated with higher scores. Further qualitative research is
needed to understand the drivers of survey response and better patient experience before
survey results can be used for quality
improvement.
Thesis (M.S.)--Tufts University, 2018.
Submitted to the Dept. of Clinical & Translational Science.
Advisor: Daniel Weiner.
Keyword: Health care management.read less - ID:
- pc289x12p
- Component ID:
- tufts:28590
- To Cite:
- TARC Citation Guide EndNote
