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The following is a summary of “Use of Hallway Beds, Radiology Studies, and Patients in Pain on Arrival to the Emergency Department Are Associated With Patient Experience,” published in the January 2025 issue of Emergency Medicine by Kuhn et al. 

Researchers conducted a retrospective study to identify characteristics associated with patient experience scores in the emergency department (ED) that had not been proposed for risk adjustment by the Centers for Medicare and Medicaid Services (CMS).  

They examined patient visits from 13 EDs across a regional health system between January 1, 2022, and December 31, 2023. A multivariable mixed-effects regression with physician-site random effects was utilized to explore the relationship between patient, clinical, and operational characteristics and ED patient experience scores. The dependent variable was the likelihood of recommending a rating (0-10 scale), which was treated as continuous. Independent variables included patient demographics (age, race, gender, ethnicity, interpreter need, and payer type), clinical factors (radiology and laboratory studies, opioid administration, patient acuity, and initial pain score), and operational variables (door-to-doc times, hallway bed placement, and National Emergency Department Overcrowding Scale [NEDOCS] level).  

The results showed 58,622 unique patient visits in the analysis. The patient experience survey response rate was 7.1% among patients discharged from ED during the study period. Black or African American patients, those with Medicaid insurance, and individuals under 40 years old were underrepresented compared to population data. Significant associations with experience ratings were found for hallway bed placement (-0.38 [95% CI, -0.53 to -0.23]), receiving radiology studies (0.27 [0.20 to 0.35]), initial pain scores (-0.08 [-0.09 to -0.06]), and NEDOCS level.  

Investigators concluded the several clinical and operational characteristics not currently used by CMS for risk adjustment were associated with patient experience scores, highlighting concerns about unclear relationships with patient-centered care constructs. 

Source: annemergmed.com/article/S0196-0644(24)01251-4/abstract