Drivers of paediatric inpatient experience: retrospective analysis of casemix factors for the Alberta Paediatric Inpatient Experience Survey in Alberta, Canada

Abstract

ObjectiveIn Alberta, the Alberta Paediatric Inpatient Experience Survey (APIES) is used as a proxy-reported measure of paediatric experience. To our knowledge, the influence of casemix factors on patient experience as measured by paediatric patient experience surveys have not been reported within Canadian paediatric samples. In this paper, we sought to determine the patient and respondent factors associated with paediatric inpatient experiences in Alberta, Canada.DesignRetrospective analysis of patient experience survey data.SettingInpatiet acute care hospitals in Alberta, Canada.Intervention and main outcome measuresRetrospective analyses were conducted using APIES surveys linked with eligible inpatient records (n=6262). Descriptive statistics were reported. χ2 tests were performed to assess distribution of casemix between general and paediatric hospitals. Logistic regression was performed with overall hospital experience as the dependent variable with casemix and hospital variables as independent variables.ResultsCasemix characteristics were unevenly distributed between general and paediatric hospitals. Compared with reference categories, older respondents, healthier patients and treatment at paediatric facilities had increased odds of providing most-positive ratings. Increased respondent education was associated with decreased odds of providing most-positive ratings. Likelihood-ratio tests showed that most casemix variables improved model fit, except for respondent relationship to the patient.ConclusionsTo improve reports of paediatric inpatient experience, administrators and providers require reliable and comparable measurement. Both the Child Hospital Consumer Assessment of Healthcare Providers and Systems and other measures of patient and family experience need to consider patient and respondent characteristics when interpreting results. Considered with other research from patient experience in Alberta, we discuss future directions and quality improvement implications.

How to analyze and link patient experience surveys with administrative data to drive health service improvement -- examples from Alberta, Canada

“…With respect to the drivers of overall experience among adults, we observed, using survey data linked with inpatient records, that younger adults, males, those with higher levels of education, those born in Canada, patients admitted to hospital on an urgent basis, those not having a primary care provider as the attending physician, and not being discharged home reported lower ratings of overall experience [33]. Among parents of hospitalized children, we observed similar results; that younger respondents, those with poorer parent-reported child health, higher levels of education, and children not treated in stand-alone pediatric hospitals reported lower odds of reporting a "top box" overall rating [34].…”

“…Drivers of overall experience (child) [34] Determine the patient and respondent factors associated with pediatric inpatient experiences.…”

Evaluation of a protocol for eliciting narrative accounts of pediatric inpatient experiences of care

“…This research should focus not only on the fidelity of the protocol for this group but also on the content and evaluative tone. Recent research showed that parents with lower education are likely to provide a less critical appraisal of their child's hospitalization experience when responding to closed‐ended survey questions 30 . If this pattern extends to open‐ended responses, then our study may underestimate the positivity of narrative responses that can be expected in samples that include a larger proportion of participants with lower educational attainment.…”

“…Recent research showed that parents with lower education are likely to provide a less critical appraisal of their child's hospitalization experience when responding to closed-ended survey questions. 30 If this pat-…”