Background: To improve quality of care, it is essential to first assess factors that influence patient experience. This study investigated whether room type influences different aspects of patient experience at an academic medical center.
Methods: Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey data from medicine patients across two hospitals from January 2018 to May 2021 were analyzed (n=1259). Top box scores were calculated for 18 survey sections to represent the percentage of patients who gave the most favorable rating on a scale system. A chi-squared test was used to identify differences in top box scores between patients in semi-private and private rooms, controlling for hospital (new hospital vs. original hospital). Differences between patients in private rooms in the new and original hospitals were also analyzed. A multivariate regression was performed to estimate the effects of room type and patient characteristics on overall top box scores. The association of a top box score as an odds ratio (OR) and adjusted odds ratio (aOR) with 95% confidence intervals (CIs) were calculated.
Results: Patients in private rooms were more likely to give a top box score (aOR=1.28), rating 11/18 survey sections higher (p< 0.05) than patients in semi-private rooms (Figure 1A). Similarly, patients in private rooms in the new hospital rated 7/18 survey sections higher than patients in private rooms in the original hospital (Figure 1B). When comparing before and after the COVID-19 pandemic, top box scores declined for sections about visitors and family (85% vs. 70%, p=0.007) and physician (77% vs. 70%, p=0.043). In addition to room type, a patient’s characteristics, such as gender, martial status, religion, language, ethnic group, and insurance type, were associated with their likelihood to give a top box score (Table 1).
Conclusions: A patient’s room type and characteristics may influence their likelihood to give a top box score. The greatest top box score differences between patients in semi-private and private rooms were associated with room, hospital environment, and visitors and family, which was expected given that these aspects are directly related to room accommodation. However, private rooms also performed better on sections that should be consistent regardless of room type, such as admission, discharge, tests and treatments, physician, and nurses. Similarly, private rooms in the new hospital scored higher than private rooms in the original hospital on tests and treatments and nurses. These results suggest that there is a “halo effect” in which a patient’s positive impression of their room influences their overall hospital experience. Thus, improving a patient’s room and hospital environment can lead to widespread increases in satisfaction about other aspects of their care.