According to study, researchers from the George Washington University (GW) and US Acute Care Solutions. There are major measurement issues in patient experience data collected from U.S. emergency departments, including high variability and limited construct validity. Patient experience data is becoming increasingly important in healthcare. The study published in the Annals of Emergency Medicine.

The data is incorporated into the U.S. Centers for Medicare and Medicaid Services public reporting and value-based purchasing models for inpatient hospital care and will be used in the implementation of the Medicare Access and CHIP Reauthorization Act, known as MACRA. The data is also used to judge physician performance and hospital performance, often driving managerial decisions such as compensation and employment, and how a hospital is perceived in the community.

Jesse Pines said, "The concept of measuring patient experience and rewarding providers who deliver a better experience is absolutely right on. No one argues with that. Yet what we found is that the data currently being gathered is not particularly reliable nor valid." Pines and his co-authors, including senior author Arvind Venkat, MD, chair of research at US Acute Care Solutions, looked at commercially-generated patient experience data from 2012-15 collected from a large sample of U.S. emergency departments.

The data evaluated satisfaction surveys gathered from patients about their experience in the emergency department with questions on how they perceived their physician and the facility. The research team found the data varied greatly month-to-month, with physician variability considerably higher than facility variability.

"Presumably, if a physician produces a experience for his or her patients, then scores should be relatively stable over time. But from month-to-month, physician scores bounced around tremendously. In some cases, a physician was rated in the 20th percentile one month, then 80th percentile the next month, then in the 30th percentile. Facility scores also bounced around, but less so," said Venkat.

However, several facility factors were found to predict higher scores: departments associated with a residency program, a higher amount of older, male, and discharged patients without Medicaid insurance, lower patient volume, less requirement for physician night coverage, and shorter lengths of stay for discharged patients.

Younger physician age, participating in patient satisfaction training, rising relative value units/visits, more commercially insured patients, higher CT/MRI use, working during less crowded times, and fewer night shifts were found to predict higher physician satisfaction scores.

Authors concluded that the survey process was marginally valid, and while some factors that predicted scores were within a hospital's control, many were not. They recommend the use of risk-adjustment models to balance the scores to account for factors outside of a hospital's control.

Pines said that a voice of the patient is increasingly important in healthcare, particularly today with rising costs of care and increasing out-of-pocket costs for our patients.