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Hotchkiss J, Ridderman E, Buftin W. Overall US Hospice Quality According to Decedent Caregivers-Natural Language Processing and Sentiment Analysis of 3389 Online Caregiver Reviews. Am J Hosp Palliat Care 2024; 41:527-544. [PMID: 37338245 DOI: 10.1177/10499091231185593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
Objectives: With an untapped quality resource in online hospice reviews, study aims were exploring hospice caregiver experiences and assessing their expectations of the hospice Medicare benefit. Methods: Topical and sentiment analysis was conducted using natural language processing (NLP) of Google and Yelp caregiver reviews (n = 3393) between 2013-2023 using Google NLP. Stratified sampling weighted by hospice size to approximate the daily census of US hospice enrollees. Results: Overall caregiver sentiment of hospice care was neutral (S = .14). Therapeutic, achievable expectations and misperceptions, unachievable expectations were, respectively, the most and least prevalent domains. Four topics with the highest prevalence, all had moderately positive sentiments: caring staff, staff professionalism and knowledge; emotional, spiritual, bereavement support; and responsive, timely or helpful. Lowest sentiments scores were lack of staffing; promises made, but not kept, pain, symptoms and medications; sped-up death, hasted, or sedated; and money, staff motivations. Significance of Results: Caregivers overall rating of hospice was neutral, largely due to moderate sentiment on achievable expectations in two-thirds of reviews mixed with unachievable expectations in one-sixth of reviews. Hospice caregivers were most likely to recommend hospices with caring staff, providing quality care, responsive to requests, and offering family support. Lack of staff, inadequate pain-symptom management were the two biggest barriers to hospice quality. All eight CAHPS measures were found in the discovered review topics. Close-ended CAHPS scores and open-ended online reviews have complementary insights. Future research should explore associations between CAHPS and review insights.
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Davlyatov G, He M, Orewa G, Qu H, Weech-Maldonado R. Are Hospice Google Ratings Correlated With Patient Experience Scores? Evidence from a National Hospice Study. Am J Hosp Palliat Care 2023; 40:1365-1370. [PMID: 36812362 DOI: 10.1177/10499091231160186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
Background: Choosing hospice care for your loved ones is often challenging. Online ratings such as Google rating has become a go-to source for most consumers. The Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey for Hospice also provides quality information about hospice care to help patients and their families make decisions. Aim: To evaluate the perceived usefulness of publicly reported hospice quality indicators and compare hospice Google ratings with hospice CAHPS scores. Methods: A cross-sectional observational study was performed to test the relationship between Google ratings and CAHPS measures in 2020. We conducted descriptive statistics for all variables. Multivariate regressions were used to assess the relationship between Google ratings and the CAHPS scores of the sample. Results: Among our sample of 1,956 hospices, the average Google rating was 4.2 out of 5 stars. CAHPS score means ranged from 75 (Help for pain and symptoms) to 90 (Treating patients with respect) out of 100. Hospice Google ratings were highly correlated with hospice CAHPS scores. For-profit and chain-affiliated hospices reported lower CAHPS scores. Hospice operational time was positively associated with CAHPS scores. The percentage of minority residents in the community and residents' educational level was negatively associated with CAHPS scores. Conclusions: Hospice Google ratings were highly correlated with patients' and families' experience scores as measured by the CAHPS survey. Consumers can use information from both resources in making decisions about hospice care.
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Affiliation(s)
- Ganisher Davlyatov
- Department of Health Administration and Policy, Hudson School of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Mengying He
- Department of Management, College of Business and Economics, California State University, Los Angeles, Los Angeles, CA, USA
| | - Gregory Orewa
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Haiyan Qu
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Robert Weech-Maldonado
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
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Hotchkiss J, Ridderman E, Hotchkiss B. Caregiver and Employee Experience Among Big Hospices-Ranking of the Largest US Hospices by Three Quality Indicators. Am J Hosp Palliat Care 2023:10499091231206481. [PMID: 37848330 DOI: 10.1177/10499091231206481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Several studies chronicle profit-making negatively impacting US hospice care quality. However, no study has reported on caregiver satisfaction expressed online by hospice. OBJECTIVES Assess the relationship between online caregiver sentiment, market share, profit status, and Consumer Assessment of Healthcare Providers and Systems (CAHPS®) scores among the 50 largest US hospices. METHODS Retrospective mixed methods of sentiment and multivariate regression analysis. Data sources were online caregiver reviews, provider CAHPS hospice survey data. RESULTS Being a larger, for-profit predicted diminished caregiver and employee satisfaction. Caregiver Sentiment and CAHPS Composite were so highly associated (r = .862, P < .001), that they are converging on overall caregiver satisfaction. With large effect, CAHPS Star Rating was significantly higher than Review Star Rating. For-profits had significantly higher overall Emotional Intensity than non-profit hospices, again with large effect. Caregiver Sentiment, Review Star Rating, and Glassdoor Composite each predicted CAHPS Composite. Lack of staffing was more frequent among for-profits (13%) than non-profits (6%). Out-of-scope expectations prevalence was 9%. CONCLUSION Caregiver and employees had better experiences with non-profits than for-profits. Anger and frustration was expressed toward large, for-profit providers more focused on admissions, profiteering, and paying dividends than actual care. The CAHPS appears to draw more satisfied caregivers. Whereas, online reviewing provides open-ended, real-time voicing of care quality concerns. Even with distinct methods, CAHPS survey and review sentiment analysis converge on caregiver satisfaction, yet CAHPS paints a much rosier picture of hospice quality than online reviews. Future research should explore sentiments by topic and hospice to increase customer advocacy.
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Hotchkiss J. Hospice Glassdoor and CAHPS® Scores-Glassdoor Scores and Hospice Financial Characteristics Predict Hospice Consumer Assessment of Healthcare Providers and Systems Scores. Am J Hosp Palliat Care 2023; 40:311-321. [PMID: 35576495 DOI: 10.1177/10499091221099475] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Recent public data transparency on both decedent caregiver satisfaction and employee satisfaction is impacting the three most essential needs of any hospice, admitting hospice enrollees, attracting hospice professionals and delivering on quality. AIM Explore the relationship between Glassdoor hospice employee recommendation data, hospice financial characteristics, and Consumer Assessment of Healthcare Providers and Systems (CAHPS®) scores among the 50 largest US hospices. DESIGN Retrospective data with multivariate regression analysis. DATA SOURCES Provider CAHPS hospice survey data from 2019-2020 and Glassdoor employee recommendation data. RESULTS Glassdoor Composite and CAHPS Composite were positively correlated (r = .469, p < .01). Glassdoor scores, profit status, and acquisition status predicted Hospice CAHPS scores and explained 44% of the variation in CAHPS Composite. Being a large, for-profit hospice in acquisition status each predicted lower CAHPS scores. Non-profit hospices had significantly higher Glassdoor and CAHPS scores than for-profit hospices. CAHPS Composite and CAHPS Star Rating have potential as global indicators to inform customers of a given hospice's overall quality on the Hospice Compare website of CMS. CONCLUSIONS Hospice leaders seeking improvements in CAHPS scores are encouraged to seek feedback on whether their own employees would recommend their hospice to a friend. Communication and responsiveness were the strongest indicators of overall hospice quality. Skelton hospice staffing models must give way to realistic models that value company culture and employee satisfaction. Hospice quality and hospice profits are not necessarily mutually exclusive. Future research should explore the difference in themes emerging from positive and negative online caregiver reviews.
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Affiliation(s)
- Jason Hotchkiss
- Chaplain and Bereavement Service Manager, Mission Healthcare, Psychology Faculty, 3587Cornerstone University, Grand Rapids, MI, USA
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Cronin RM, Yang M, Hankins JS, Byrd J, Pernell BM, Kassim A, Adams-Graves P, Thompson AA, Kalinyak K, DeBaun M, Treadwell M. Association between hospital admissions and healthcare provider communication for individuals with sickle cell disease. ACTA ACUST UNITED AC 2020; 25:229-240. [PMID: 32552526 DOI: 10.1080/16078454.2020.1780737] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: To test the hypothesis that caregivers' or adult participants' low ratings of provider communication are associated with more hospital admissions among adults and children with sickle cell disease (SCD), respectively. Secondarily, we determined whether there was an association between the caregivers' or participants' health literacy and rating of providers' communication. Methods: Primary data were collected from participants through surveys between 2014 and 2016, across six sickle cell centers throughout the U.S. In this cross-sectional cohort study, 211 adults with SCD and 331 caregivers of children with SCD completed surveys evaluating provider communication using the Consumer Assessment of Healthcare Providers and Systems (CAHPS), healthcare utilization, health literacy, and other sociodemographic and behavioral variables. Analyses included descriptive statistics, bivariate analyses, and logistic regression. Results: Participants with better ratings of provider communication were less likely to be hospitalized (odds ratio (OR) = 0.54, 95% confidence interval (CI) = [0.35, 0.83]). Positive ratings of provider communication were associated with fewer readmissions for children (OR = 0.23, 95% CI = [0.09, 0.57]). Participants with better ratings of provider communication were less likely to rate their health literacy as lower (regression coefficient (B) = -0.28, 95% CI = [-0.46, -0.10]). Conclusions: Low ratings of provider communication were associated with more hospitalizations and readmissions in SCD, suggesting the need for interventions targeted at improving patient-provider communication which could decrease hospitalizations for this population.
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Affiliation(s)
- Robert M Cronin
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Manshu Yang
- Department of Psychology, University of Rhode Island, Kingston, RI, USA.,American Institutes for Research, Chapel Hill, NC, USA
| | - Jane S Hankins
- Department of Hematology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Jeannie Byrd
- Department of Pediatrics, Division of Hematology/Oncology, Vanderbilt-Meharry Center for Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Brandi M Pernell
- Department of Pediatrics, Division of Hematology/Oncology, Vanderbilt-Meharry Center for Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Pediatrics, Division of Hematology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Adetola Kassim
- Department of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Patricia Adams-Graves
- Department of General Internal Medicine and Hematology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Alexis A Thompson
- Department of Pediatrics, Department of Medicine, Northwestern University, Chicago, IL, USA
| | - Karen Kalinyak
- Division of Hematology in Cancer and Blood Diseases Institute, University of Cincinnati, Cincinnati, OH, USA
| | - Michael DeBaun
- Department of Pediatrics, Division of Hematology/Oncology, Vanderbilt-Meharry Center for Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Marsha Treadwell
- Department of Hematology/Oncology, UCSF Benioff Children's Hospital Oakland, Oakland, CA, USA
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