OBJECTIVE: The aim of this study was to estimate the differences in RR and patient representation between MM and single-mode approaches and to identify hospital characteristics associated with the largest RR differences from MM of single-mode protocols (mail-only, phone-only).
METHODS: Patients were randomized within hospitals to one of 3 modes (mail-only, phone-only, MM).
METHODS: A total of 17,415 patients from the 51 nationally representative US hospitals participating in a randomized HCAHPS mode experiment.
RESULTS: Mail-only RRs were lowest for ages 18-24 (7%) and highest for ages 65+ (31%-35%). Phone-only RRs were 24% for ages 18-24, increasing to 37%-40% by ages 55+. MM RRs were 28% for ages 18-24, increasing to 50%-60% by ages 65-84. Lower hospital-level mail-only RRs strongly predicted greater gains from MM. For example, a hospital with a 15% mail-only RR has a predicted MM RR >40% (with >25% occurring in telephone follow-up).
CONCLUSIONS: MM increased representation of hard-to-reach (especially young adult) patients and hospital RRs in all mode experiment hospitals, especially in hospitals with low mail-only RRs.
目的:本研究的目的是估计MM和单模式方法之间RR和患者表现的差异,并确定与单模式方案MM最大RR差异相关的医院特征(仅邮件,仅限电话)。
方法:患者在医院内随机分为3种模式之一(仅邮寄,只有电话,MM)。
方法:来自美国51家全国代表性医院的17,415名患者参与了一项随机HCAHPS模式实验。
结果:仅邮件RR在18-24岁年龄段最低(7%),在65岁以上年龄段最高(31%-35%)。18-24岁的纯电话RR为24%,到55岁以上时增加到37%-40%。18-24岁的MMRR为28%,到65-84岁增加到50%-60%。较低的医院级别的仅邮件RR强烈预测了MM的更大收益。例如,仅邮件RR为15%的医院的MMRR预测>40%(电话随访中>25%)。
结论:在所有模式实验医院中,MM增加了难以到达(尤其是年轻成人)患者和医院RR的代表,尤其是在只有邮件的Rs较低的医院。