The emergence of the COVID-19 pandemic posed unparalleled challenges for acute-care hospitals. To control the spread of COVID-19 infection, hospitals adopted new protocols, including social distancing and restricted visitor access.
A recent cohort study looked to describe differences in 2020 to 2021 patient experiences to assess whether the COVID-19 pandemic was adversely linked with patients’ care experiences.
This cohort study conducted a comparison between data from the years 2020 to 2021 and data from 2018 to 2019. The study focused on a total of 3,900,887 respondents who had participated in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey and were subsequently discharged from 3,381 participating hospitals in the United States. The data analysis for this study took place between 2022 and 2023.
According to the analysis, by the fourth quarter of 2021, a summary measure reflecting patient experiences was observed to be 3.6 percentage points lower across all hospitals. This decline was in comparison to what would have been anticipated in the absence of the pandemic. This reduction is considered to have a medium effect size in the context of patient experience measurements.
The study suggested substantial decreases in scores related to staff responsiveness and cleanliness. These declines are attributed to significant factors, such as high absenteeism in the hospital workforce and delays in care linked to the fact that staff had to wear PPE in response to the pandemic.
The decline in the overall rating and hospital recommendation measures lagged the decline in more specific HCAHPS measures. This could be a result of patients initially giving hospitals patience or having lower expectations during the start of the pandemic. As time went on and the challenges persisted, patients' assessments became more reflective of their actual experiences.
The study makes a noteworthy observation: hospitals that initially demonstrated resilience in their HCAHPS scores faced a decline in these scores that was nearly equivalent to the decline seen in hospitals that faced lower performance prior to the pandemic. Additionally, hospitals that were lower performing and suffered from staffing shortages pre-pandemic may have been less resilient to challenges during the pandemic such as reduced staff availability.
Despite this finding, by the fourth quarter of 2021, even pre-pandemic high-performing hospitals revealed similar declines, which indicates the enduring impact of the pandemic on healthcare systems and patients’ experiences of care.
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