Effects of Patients’ Scores on Health Care

The aim of this discussion is to come up with an evaluation table of the studies that will form part of the literature reviewed for evidence. Also, demonstrating the search tracker for the evidence of this evidence-based topic is another primary objective.

Search Tracker

In my effort to locate relevant evidence for this study, I utilized three databases (COCHRANE Library, CINAHL, and PubMed). First, I established the keywords from my PICOT question (As medical practitioners what are the positive and negative outcomes of HCAP scores on reimbursement and cost because of patient satisfaction surveys increase or decrease in hospital improvements over the past 8 years).The key words used were effects, patient satisfaction, and healthcare cost. After that, I searched them in the databases to locate the appropriate evidence for this study. To ensure that Iobtained alimited number of studies, I limited the search to studies done after 2012 to date. Consistent with my way of searching for studies was the search strategy proposed by another study done in 2010 (Stillwell, Fineout-Overholt, Melnyk, & Williamson, 2010).

EBP Research Table

Citation	Abstract/Purpose	Research/ Study	Methods	Setting/ Subject	Findings/ Results	Variables	Implications for Practice
Stanowski, A. C., Simpson, K., & White, A. (2015). Pay for Performance: Are Hospitals Becoming More Efficient in Improving Their Patient Experience?. Journal Of Healthcare Management / American College Of Healthcare Executives, 60(4), 268-285.	Following the CMS implementation of P4P system, the researcher aimed at establishing if a relationship between inpatient costs and overall hospital rating on the HCAHPS exist.	A correlation quantitative study design was the researcher’s preference for this study.	The sources of data used include Cleverley and Associates (Medicare cost report financial data), US Lifeline’s Major Accounts Exchange (System definition), CMS (HCAHPS) and Council of Teaching Hospitals and Health Systems (Teaching status)	The study setting was all hospitals in USA that have an entitlement to CMS reimbursement.	Hospitals associated with high cost have increased levels of positive patient experiences.	Independent variable: Hospitals costs Dependent variable: HCAPHS scores	Hospitals must enhance their performance by improving the quality of care given to the patients.
Elliott, M. N., Beckett, M. K., Lehrman, W. G., Cleary, P., Cohea, C. W., Giordano, L. A., & … Damberg, C. L. (2016). Understanding The Role Played By Medicare’s Patient Experience Points System In Hospital Reimbursement. Health Affairs, 35(9), 1673-1680. doi:10.1377/hlthaff.2015.0691	The study’s main objective was to examine the three elements of patient experience points (achievement, improvement, and consistency) affected reimbursement following the $1.4 billion reimbursed to hospitals Medicare Hospital VBP program.	The study utilized a quantitative study design.	The researchers used HCAHPS results for 3152 inpatient prospective payment system hospitals. In data analysis, the researcher calculated correlations, variances, and means	The study population included 3152 inpatient prospective payment system hospitals that are eligible for the HCAHPS component of the Hospital VBP.	Achievement had the biggest influence on payments while improvement and consistency payments were more beneficial for low-performing hospitals.	Independent variables: Achievement, Improvement, and Consistency Dependent variable: Reimbursement	The implication drawn from this study is that there is need to strengthen the scoring system since it has significantly improved the quality of care provided in many hospitals through reduction of the undesired effects.
Hibbard, J. H., Greene, J., & Overton, V. (2013). Patients with lower activation associated with higher costs; delivery systems should know their patients’‘scores’. Health affairs, 32(2), 216-222.	Given the new trend of health care delivery systems to utilize patient activation scores to improve the patient’s health care experience, the researcher intended to establish the relationship between patient activation scores and cost of care incurred.	The study utilized a cross-sectional quantitative study design.	The researcher sourced patient activation and care cost data from individual electronic health records and Fairview administrative database respectively.	The study took place in 41primary care facilities, specialty care clinics, and hospitals within Minnesota. The study population included patients above 18years, enrolled to Fairview Health Servicesand visited primary care facility in 2010.	The researcher established that there is substantial evidence that patient activation levels affect the health care cost.	Independent variable: Patient activation score Dependent variable: Care cost	The focus of health care facilities should enhance patient activation levels to bring down their cost of care.
Kennedy, G. D., Tevis, S. E., & Kent, K. C. (2014). Is there a relationship between patient satisfaction and favorable outcomes?. Annals of surgery, 260(4), 592.	Due to the insistence by Centers for Medicare and Medicaid Services for patient satisfaction, the researchers aimed at evaluating whether there is a relationship between patient satisfaction and favorable outcomes.	The researcher used a correlation quantitative study design.	The UHC database was essential in the selection of Medical centers from 2011 to 2012 where the study would take place. The researcher used descriptive statistics and Chi-squares to analyze the data obtained from the study.	The study setting was all medical centers and hospitals across the USA whose data exists in the UHC database. The study population included all adult patients discharged from the surgery unit.	The study established a significant association of high patient satisfaction with variables like large hospitals, high surgical volume, and low mortality (p<0.001).	Independent variable: Patient satisfaction Dependent variable: hospital characteristics, process measure compliance, and surgical outcomes	Patient satisfaction affects many aspects of health care outcomes and thus enhancing it is essential in getting positive health care outcomes.

Abbreviations

CMS-Centers for Medicare and Medicaid Services

HCAHPS-Hospital Consumer Assessment of Healthcare Providers Systems

P4P-Pay-4-Performance

UHC-University HealthSystem Consortium

VBP- Value-Based Purchasing

References

Elliott, M. N., Beckett, M. K., Lehrman, W. G., Cleary, P., Cohea, C. W., Giordano, L. A., & … Damberg, C. L. (2016). Understanding The Role Played By Medicare’s Patient Experience Points System In Hospital Reimbursement. Health Affairs, 35(9), 1673-1680. doi:10.1377/hlthaff.2015.0691

Hibbard, J. H., Greene, J., & Overton, V. (2013). Patients with lower activation associated with higher costs; delivery systems should know their patients’‘scores’. Health affairs, 32(2), 216-222.

Kennedy, G. D., Tevis, S. E., & Kent, K. C. (2014). Is there a relationship between patient satisfaction and favorable outcomes?. Annals of surgery, 260(4), 592.

Stanowski, A. C., Simpson, K., & White, A. (2015). Pay for Performance: Are Hospitals Becoming More Efficient in Improving Their Patient Experience?. Journal Of Healthcare Management / American College Of Healthcare Executives, 60(4), 268-285.

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010). Evidence-based practice, step by step: Searching for the evidence. AJN The American Journal of Nursing, 110(5), 41-47.

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