Demographics matter: the potentially disproportionate effect of COVID-19 on hospital ratings

Int J Qual Health Care. 2021 Mar 9;33(1):mzab036. doi: 10.1093/intqhc/mzab036.

Abstract

Objective: To identify how features of the community in which a hospital serves differentially relate to its patients' experiences based on the quality of that hospital.

Design: A Finite Mixture Model (FMM) is used to uncover a mix of two latent groups of hospitals that differ in quality. In the FMM, a multinomial logistic equation relates hospital-level factors to the odds of being in either group. And a multiple linear regression relates the characteristics of communities served by hospitals to the patients' expected ratings of their experiences at hospitals in each group. Thus, this association potentially varies with hospital quality. The analysis was conducted via Stata.

Setting: Hospital Ratings are measured by Hospital Compare using the HCAHPS survey, a patient satisfaction survey required by the Centers for Medicare and Medicaid Services (CMS) for hospitals in the United States. Participants: 2,816 Medicare-certified acute care hospitals across all US states.

Keywords: COVID-19; HCAHPS; community demographics; hospital ratings.

MeSH terms

  • Age Factors
  • COVID-19 / epidemiology*
  • Centers for Medicare and Medicaid Services, U.S. / standards*
  • Female
  • Humans
  • Linear Models
  • Male
  • Patient Satisfaction / statistics & numerical data
  • Quality Indicators, Health Care / statistics & numerical data*
  • Residence Characteristics / statistics & numerical data
  • SARS-CoV-2
  • Sex Factors
  • Socioeconomic Factors*
  • United States / epidemiology