384家美国医院患者体验纵向分析：潜在评分2021年降0.106、2022年回升0.195
一项11月14日发表于《科学报告》的研究分析了384家美国医院的患者体验数据，用潜在服务质量模型追踪评分随时间的变化。数据为 CMS 的 HCAHPS 十个领域星级评分，覆盖2017至2019年与2021至2022年，共1920个观测值。
方法上，研究把等级反应模型与日历时间增长模型结合，并对两个阶段各做1000次以医院为单位的自助重抽样。样本的平均拟合潜在评分从2019年到2021年下降0.106（95%区间负0.159至负0.057）。
随后评分回升：从2021年到2022年上升0.195（95%区间0.152至0.238），并超过2019年均值，高出0.089（95%区间0.038至0.138）。替代纵向模型与观测分数分析显示出相同形态。
区分度最高的领域是总体评分、照护衔接与护士沟通。教学属性与所有权相关的变化差异在主模型中经多重检验调整后尚无定论；一个探索性模型显示，营利性医院2022年相对预测趋势的偏离比政府医院更负。
作者来自 Central Washington University 与 University of South Florida。作者表示，该方法通过把测量假设与不确定性显性化，支持患者体验监测；文中时间层面的发现描述的是研究年份之间的关联。本研究未获经费资助。
Across 384 U.S. Hospitals, Latent Patient-Experience Scores Fell 0.106 Into 2021, Then Rebounded 0.195 in 2022
A study published November 14 in Scientific Reports analysed patient experience data from 384 U.S. hospitals using latent service quality modeling. The data were the ten CMS HCAHPS domain star ratings across 2017-2019 and 2021-2022, comprising 1,920 observations.
The team combined a graded response model with calendar-time growth modeling, with 1,000 hospital bootstrap refits of both stages. Mean fitted latent scores for the sample declined from 2019 to 2021 by 0.106 (95% interval -0.159 to -0.057).
Scores then rebounded, rising 0.195 from 2021 to 2022 (95% interval 0.152 to 0.238), and exceeded the 2019 mean by 0.089 (95% interval 0.038 to 0.138). Alternative longitudinal models and observed-score analyses showed the same pattern.
Overall rating, care transition and nurse communication had the highest discrimination estimates. Teaching- and ownership-related contrasts were inconclusive after adjustment for multiple tests in the primary model, while an exploratory model showed a more negative 2022 deviation from projected trends for for-profit than for government hospitals.
The authors are affiliated with Central Washington University and the University of South Florida. They say the approach supports patient-experience monitoring by making measurement assumptions and uncertainty explicit, and that the temporal findings describe associations across study years. No funding was received for the research.
来源：Scientific Reports
发布：GSM·美国（发布链接）
图片来源：图：位于 Chandler 的 Chandler Regional Medical Center 住院大楼。来源：Sammi Brie，Wikimedia Commons，CC BY 4.0。 / Photo: The inpatient tower of Chandler Regional Medical Center in Chandler. Source: Sammi Brie, Wikimedia Commons, CC BY 4.0.
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