Becker's Clinical Quality & Infection Control

62 PATIENT SATISFACTION AND QUALITY MEASUREMENT CMS 5-Star Hospitals Have Lower Mortality and Readmission Rates, Study Finds By Heather Punke E ven though CMS' star ratings system for hospitals is based solely on patient experience scores, researchers from Harvard have found that higher rated hospitals do in fact have lower mortality and readmission rates than their lower rated counterparts. e research was published in JAMA in April. For the study, Harvard T. H. Chan School of Public Health researchers looked at the association between 3,076 hospitals' star ratings as of October 2015 and their mortality and readmissions rates across three conditions (heart attacks, pneumo- nia and heart failure) using Medicare data. ey also adjusted for hospital and patient characteristics. High star ratings were associated with lower readmission rates: • Five-star hospitals: 18.7 percent read- mission rate • Four-star hospitals: 20.2 percent • ree-star hospitals: 21 percent • Two-star hospitals: 21.8 percent • One-star hospitals: 22.9 percent Additionally, hospitals with more stars had lower mortality rates: • Five-star hospitals: 9.8 percent mor- tality rate • Four-star hospitals: 10.4 percent • ree-star hospitals: 10.5 percent • Two-star hospitals: 10.7 percent • One-star hospitals: 11.2 percent is data could ease the fears of some ex- perts who spoke out against Hospital Compare's star rating system when it was released last year because it only touches on patient experience and does not include outcomes data. "ese findings should be encouraging for policymakers and consumers; choosing five-star hospitals does not seem to lead to worse outcomes and in fact may be driving patients to better institutions," the authors concluded. "It is reassuring that patients can use the star ratings in guiding their health- care-seeking decisions given that hospitals with more stars not only offer a better expe- rience of care, but also have lower mortality and readmissions." n Study Suggests Yelp can Supplement the Federal Government's Survey of Patients' Hospital Experiences By Kelly Gooch Y elp reviews of hospitals cover topics not found in more traditional patient experience surveys, according to the results of a study published in the April issue of Health Affairs. For the study, researchers at the Perelman School of Med- icine at the University of Pennsylvania compared 16,862 Yelp reviews of 1,352 hospitals to HCAHPS reviews of the same institutions. The authors found the domains included in Yelp reviews covered the majority of HCAHPS domains. However, Yelp reviews covered an additional 12 domains not found in HCAHPS: cost of hospital visit, insurance and billing, ancil- lary testing, facilities, amenities, scheduling, compassion of staff, family member care, quality of nursing, quality of staff, quality of technical aspects of care and specific type of medical care. Furthermore, the study found the majority of Yelp topics that most strongly correlate with positive reviews are not measured or reported by HCAHPS. These included: caring doctors, nurses, and staff; comforting; surgery/pro- cedure and peri-op; and labor and delivery. "These topics that are covered within the Yelp reviews are important because they relate to the interpersonal relationships of patients with physicians, nurses, and staff," the study's lead author Benjamin L. Ranard, a junior fellow at the Penn Social Media and Health Innovation Lab, and a combined MD/MS in Health Policy Research student at the Perelman School of Medicine, said, according to a news release. "Prospective patients are likely to want to know how caring and comforting caregivers are in various departments of a hospital." The study found two of the top five Yelp categories most strongly associated with negative Yelp review ratings — cost of hospital visit and insurance and billing — are also not covered by HCAHPS domains. Overall, the authors concluded online consumer review platforms such as Yelp can supplement information pro- vided by more traditional patient-experience surveys and help patients, providers and policymakers understand and assess hospital quality. n

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