Will Improvements in Patient Experience With Care Impact Clinical and Quality of Care Outcomes?

Abstract

Background: Patient experiences with health care have been widely used as benchmark indicators of quality for providers, health care practices, and health plans.Objective: The objective of this study was to summarize the literature regarding the associations between Consumer Assessment of Healthcare Providers and Systems (CAHPS) patient experiences and clinical and quality outcomes.Research Design: A systematic review of the literature was completed using PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature on December 14, 2019. Separate searches were conducted to query terms identifying CAHPS surveys with clinical and quality outcomes of care. Two reviewers completed all components of the search process.Study Selection: Studies investigating associations between CAHPS composite ratings and health care sensitive clinical outcomes or quality measures of care were included in this review. Studies were excluded if they did not investigate patient experiences using CAHPS composite ratings or if CAHPS composites were not treated as the independent variable.Results: Nineteen studies met inclusion criteria, 10 investigating associations of CAHPS composite ratings with clinical outcomes and 9 investigating these associations with quality measures. Patientprovider communication was the most studied CAHPS composite rating and was significantly associated with self-reported physical and mental health, frequency of emergency room visits and inpatient hospital stays, hospitalization length, and CAHPS personal physician global ratings.Conclusions: Ratings of patient experience with care may influence clinical and quality outcomes of care. However, key inconsistencies between studies affirm that more research is needed to solidify this conclusion and investigate how patient experiences differentially relate to outcomes for various patient groups.

Disparities in Youth and Family Experiences of System-of-Care Principles by Level of Youth Need

“…In addition to demonstrating disparities in youth and families’ experience of system-of-care principles by level of youth need, findings of this study indicated that youth experienced more improvement in their caregiver-reported well-being when their services were more aligned with system-of-care principles. This finding is consistent with other studies which showed that patient ratings of their care experiences predict the clinical safety and effectiveness of care (Doyle et al, 2013 ; Navarro et al, 2021 ). It also adds to research showing that when families experience care that is more aligned with system-of-care principles, youths experience better clinical outcomes (Hernandez et al, 2001 ; Stephens et al, 2004 ; Williams et al, 2021 ).…”

“…This concern is mitigated by the explicit centering of family perspectives within systems-of-care (Stroul et al, 2010 ), including in evaluation activities, and by the emphasis on patient-centeredness in healthcare quality frameworks (Co et al, 2011 ). In addition, there is evidence that patient-reported experiences of care predict healthcare safety and clinical effectiveness (Doyle et al, 2013 ; Navarro et al, 2021 ). Nonetheless, future research should incorporate additional measures of adherence to system-of-care principles to substantiate and extend the findings presented here.…”

The Satisfaction With Care of Patients With Schizophrenia in Taiwan: A Cross-Sectional Survey of Patient-Centered Care Domains

“…The most important PCC factor for schizophrenia relates to information, education, and communication. A recent systematic review showed patient–provider communication to be significantly associated with self-reported physical and mental health (Navarro et al, 2021). Pestana-Santos et al (2018) found that patients with schizophrenia consider clinical communication necessary when assessing psychiatrists' communication skills.…”

“…PROMs are important for patients with schizophrenia because pharmacologic interventions should be combined with evidence-based nonpharmacologic treatments and patient-reported outcomes should be employed (Correll, 2020). Finally, a systematic review study also highlighted that higher satisfaction may ultimately improve long-term, simple objective outcomes in patients (Navarro et al, 2021). Thus, based on the above, satisfaction was considered a final patient outcome in this study.…”

Patient Attitudes and Desirability Regarding Immediate Sequential Bilateral Cataract Surgery

“…There is data suggesting that improved patient experience with medical care will improve clinical outcomes. 23 However, studies evaluating routine medical care have struggled to characterize effective outcome measures that will determine patient satisfaction. 24 With specific regards to ISBCS, we have identified certain patient circumstances that will affect patient attitudes and their economic burden.…”