Collections > Electronic Theses and Dissertations > Drivers of Patient Satisfaction and Effects of Demographics on the HCAHPS Survey

Although patient satisfaction has traditionally been a quality indicator measured by most hospitals, it has taken on greater importance in light of the recent inclusion of this metric as a component of Medicare's hospital inpatient Value-Based Purchasing (VBP) program. Acute-care hospitals are financially rewarded or penalized based on the quality of care that they provide to Medicare patients with payments starting at 1.25% of hospitals' base operating diagnosis-related groups (DRG) payment for Federal Fiscal Year (FFY) 2014 and increasing incrementally over the next three years. How patients respond to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) overall rating question, in which they choose a number from 0 to 10 to "rate this hospital during your stay," can have tremendous ongoing financial implications. The objectives of this Doctor of Nursing Practice project were to: 1) analyze HCAHPS discharge data from 7/1/13 to 12/31/13 for inpatient acute care units at UNC Hospitals (UNCH) to identify the drivers of patient satisfaction specific to UNCH, and 2) explore the potential effects of demographic differences on perceptions and ratings of the care provided. Decision-tree analytics were used to identify which survey items are most influential in framing the patient's total experience and the effect of demographical differences on these scores. Based on the analysis, potential strategies are suggested to improve patient satisfaction scores for key drivers of patient satisfaction on the survey.