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Patient Experience at US Hospitals Following the Caregiver Advise, Record, Enable (CARE) Act

IMPORTANCE: Communication with caregivers is often not established or standardized during hospitalization. The Caregiver Advise, Record, Enable (CARE) Act is a state-level policy designed to facilitate communication among patients, caregivers, and clinical care teams during hospitalization to improv...

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Autores principales: Lee, Courtney R., Taggert, Elizabeth, Coe, Norma B., Chatterjee, Paula
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Medical Association 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10152302/
https://www.ncbi.nlm.nih.gov/pubmed/37126344
http://dx.doi.org/10.1001/jamanetworkopen.2023.11253
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author Lee, Courtney R.
Taggert, Elizabeth
Coe, Norma B.
Chatterjee, Paula
author_facet Lee, Courtney R.
Taggert, Elizabeth
Coe, Norma B.
Chatterjee, Paula
author_sort Lee, Courtney R.
collection PubMed
description IMPORTANCE: Communication with caregivers is often not established or standardized during hospitalization. The Caregiver Advise, Record, Enable (CARE) Act is a state-level policy designed to facilitate communication among patients, caregivers, and clinical care teams during hospitalization to improve patient experience; 42 states have passed this policy since 2014, but whether it was associated with achieving these goals remains unknown. OBJECTIVE: To determine whether passage of the CARE Act was associated with improvements in patient experience. DESIGN, SETTING, AND PARTICIPANTS: This cohort study used a difference-in-differences analysis of short-term, acute-care US hospitals from 2013 to 2019 to analyze changes in patient experience before vs after CARE Act implementation in hospitals located in states that passed the CARE Act compared with those in states that did not. Analyses were performed between September 1, 2021, and July 31, 2022. EXPOSURE: Time-varying indicators for whether a hospital was in a state that passed the CARE Act. MAIN OUTCOMES AND MEASURES: Patient-reported experience via the Hospital Consumer Assessment of Healthcare Providers and Systems survey. RESULTS: A total of 2763 hospitals were included, with 2188 hospitals in CARE Act states and 575 in non–CARE Act states. There were differential improvements in patient experience in the measures of communication with nurses (unadjusted mean [SD] score, 78.40% [0.42%]; difference, 0.18 percentage points; 95% CI, 0.07-0.29 percentage points; P = .002), communication with physicians (mean [SD] score, 80.00% [0.19%]; difference, 0.17 percentage points; 95% CI, 0.06-0.28 percentage points; P = .002), and receipt of discharge information (mean [SD] score, 86.40% [0.22%]; difference, 0.11 percentage points; 95% CI, 0.02-0.21 percentage points; P = .02) among CARE Act states compared with non–CARE Act states after policy passage. In subgroup analyses, improvements were larger among hospitals with lower baseline Hospital Consumer Assessment of Healthcare Providers and Systems performance on measures of communication with nurses, communication with physicians, and overall hospital rating. CONCLUSIONS AND RELEVANCE: These findings suggest that implementation of the CARE Act was associated with improvements in several measures of patient experience. Policies that formally incorporate caregivers into patient care during hospitalization may improve patient outcomes.
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spelling pubmed-101523022023-05-03 Patient Experience at US Hospitals Following the Caregiver Advise, Record, Enable (CARE) Act Lee, Courtney R. Taggert, Elizabeth Coe, Norma B. Chatterjee, Paula JAMA Netw Open Original Investigation IMPORTANCE: Communication with caregivers is often not established or standardized during hospitalization. The Caregiver Advise, Record, Enable (CARE) Act is a state-level policy designed to facilitate communication among patients, caregivers, and clinical care teams during hospitalization to improve patient experience; 42 states have passed this policy since 2014, but whether it was associated with achieving these goals remains unknown. OBJECTIVE: To determine whether passage of the CARE Act was associated with improvements in patient experience. DESIGN, SETTING, AND PARTICIPANTS: This cohort study used a difference-in-differences analysis of short-term, acute-care US hospitals from 2013 to 2019 to analyze changes in patient experience before vs after CARE Act implementation in hospitals located in states that passed the CARE Act compared with those in states that did not. Analyses were performed between September 1, 2021, and July 31, 2022. EXPOSURE: Time-varying indicators for whether a hospital was in a state that passed the CARE Act. MAIN OUTCOMES AND MEASURES: Patient-reported experience via the Hospital Consumer Assessment of Healthcare Providers and Systems survey. RESULTS: A total of 2763 hospitals were included, with 2188 hospitals in CARE Act states and 575 in non–CARE Act states. There were differential improvements in patient experience in the measures of communication with nurses (unadjusted mean [SD] score, 78.40% [0.42%]; difference, 0.18 percentage points; 95% CI, 0.07-0.29 percentage points; P = .002), communication with physicians (mean [SD] score, 80.00% [0.19%]; difference, 0.17 percentage points; 95% CI, 0.06-0.28 percentage points; P = .002), and receipt of discharge information (mean [SD] score, 86.40% [0.22%]; difference, 0.11 percentage points; 95% CI, 0.02-0.21 percentage points; P = .02) among CARE Act states compared with non–CARE Act states after policy passage. In subgroup analyses, improvements were larger among hospitals with lower baseline Hospital Consumer Assessment of Healthcare Providers and Systems performance on measures of communication with nurses, communication with physicians, and overall hospital rating. CONCLUSIONS AND RELEVANCE: These findings suggest that implementation of the CARE Act was associated with improvements in several measures of patient experience. Policies that formally incorporate caregivers into patient care during hospitalization may improve patient outcomes. American Medical Association 2023-05-01 /pmc/articles/PMC10152302/ /pubmed/37126344 http://dx.doi.org/10.1001/jamanetworkopen.2023.11253 Text en Copyright 2023 Lee CR et al. JAMA Network Open. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the CC-BY License.
spellingShingle Original Investigation
Lee, Courtney R.
Taggert, Elizabeth
Coe, Norma B.
Chatterjee, Paula
Patient Experience at US Hospitals Following the Caregiver Advise, Record, Enable (CARE) Act
title Patient Experience at US Hospitals Following the Caregiver Advise, Record, Enable (CARE) Act
title_full Patient Experience at US Hospitals Following the Caregiver Advise, Record, Enable (CARE) Act
title_fullStr Patient Experience at US Hospitals Following the Caregiver Advise, Record, Enable (CARE) Act
title_full_unstemmed Patient Experience at US Hospitals Following the Caregiver Advise, Record, Enable (CARE) Act
title_short Patient Experience at US Hospitals Following the Caregiver Advise, Record, Enable (CARE) Act
title_sort patient experience at us hospitals following the caregiver advise, record, enable (care) act
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10152302/
https://www.ncbi.nlm.nih.gov/pubmed/37126344
http://dx.doi.org/10.1001/jamanetworkopen.2023.11253
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