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. 2023 Aug 25;4(8):e232766. doi: 10.1001/jamahealthforum.2023.2766

Table 2. Estimated Association of the COVID-19 Pandemic With HCAHPS-SS in Models as Stratified by Hospital Characteristicsa.

2020 Q1/2020 (n = 5 861 470 patients; n = 1648 hospitals) Q2/2020 (n = 5 807 876 patients; n = 1737 hospitals) Q3/2020 (n = 6 118 270 patients; n = 3224 hospitals) Q4/2020 (n = 6 104 234 patients; n = 3295 hospitals)
Est (SE), % P value Est (SE), % P value Est (SE), % P value Est (SE), % P value
Prepandemic (2019) overall star rating
Overall star rating, 1-2 −0.01 (0.11) .93 −1.56 (0.11) <.001 −2.18 (0.09) <.001 −1.92 (0.09) <.001
Overall star rating, 3 −0.01 (0.11) .92 −1.28 (0.11) <.001 −2.02 (0.09) <.001 −2.08 (0.10) <.001
Overall star rating, 4 −0.11 (0.10) .29 −0.95 (0.10) <.001 −1.97 (0.09) <.001 −1.90 (0.09) <.001
Overall star rating, 5 0.04 (0.13) .76 −0.87 (0.14) <.001 −1.73 (0.12) <.001 −1.70 (0.12) <.001
NA stars −0.08 (0.26) .78 −1.00 (0.26) <.001 −1.48 (0.22) <.001 −1.38 (0.22) <.001
2021 Q1/2021 (n = 6 099 727 patients; n = 3219 hospitals) Q2/2021 (n = 6 109 713 patients; n = 3181 hospitals) Q3/2021 (n = 6 084 396 patients; n = 3232 hospitals) Q4/2021 (n = 5 990 289 patients; n = 3137 hospitals)
Overall star rating, 1-2 −2.21 (0.12) <.001 −2.62 (0.12) <.001 −3.66 (0.12) <.001 −3.74 (0.13) <.001
Overall star rating, 3 −2.06 (0.12) <.001 −2.46 (0.12) <.001 −3.52 (0.12) <.001 −3.65 (0.13) <.001
Overall star rating, 4 −1.67 (0.12) <.001 −2.10 (0.12) <.001 −3.18 (0.12) <.001 −3.58 (0.12%) <.001
Overall star rating, 5 −1.63 (0.16) <.001 −2.01 (0.16) <.001 −3.00 (0.16) <.001 −3.20 (0.17) <.001
NA stars −1.73 (0.29) <.001 −2.13 (0.29) <.001 −2.74 (0.29) <.001 −3.32 (0.30) <.001
2020 Q1/2020 (n = 5 861 470 patients; n = 1648 hospitals) Q2/2020 (n = 5 807 876 patients; n = 1737 hospitals) Q3/2020 (n = 6 118 270 patients; n = 3224 hospitals) Q4/2021 (n = 5 990 289 patients; n = 3295 hospitals)
Prepandemic (2019) staffing levels
Q1 (lowest staffing) −0.01 (0.12) .90 −1.83 (0.13) <.001 −2.27 (0.10) <.001 −2.12 (0.11) <.001
Q2 0.05 (0.09) .61 −1.14 (0.10) <.001 −2.08 (0.08) <.001 −1.98 (0.08%) <.001
Q3 −0.17 (0.10) .10 −0.95 (0.10) <.001 −1.82 (0.09) <.001 −1.73 (0.09) <.001
Q4 (highest staffing) 0.06 (0.15) .69 −0.98 (0.16) <.001 −1.63 (0.13) <.001 −1.72 (0.13) <.001
2021 Q1/2021 (n = 6 099 727 patients; n = 3219 hospitals) Q2/2021 (n = 6 109 713 patients; n = 3181 hospitals) Q3/2021 (n = 6 084 396 patients; n = 3232 hospitals) Q4/2021 (n = 5 990 289 patients; n = 3137 hospitals)
Q1 (lowest staffing) −2.26 (0.13) <.001 −2.65 (0.13) <.001 −3.77 (0.14) <.001 −3.74 (0.14) <.001
Q2 −1.94 (0.10) <.001 −2.39 (0.10) <.001 −3.37 (0.10) <.001 −3.49 (0.11) <.001
Q3 −1.86 (0.11) <.001 −2.12 (0.12) <.001 −3.22 (0.12) <.001 −3.54 (0.12) <.001
Q4 (highest staffing) −1.44 (0.18) <.001 −2.09 (0.18) <.001 −2.94 (0.18) <.001 −3.62 (0.18) <.001

Abbreviations: est, estimation; HCAHPS-SS, Hospital Consumer Assessment of Healthcare Providers and Systems summary score; NA, not applicable; Q, quarter.

a

Each model included Q1/2018 to Q4/2019 discharges, plus 1 post-2019 quarter (each model had 9 quarters). Each model was limited to hospitals with at least 25 completed surveys in their post-2019 quarter and included data from all quarters for which these hospitals had at least 25 completed surveys. Models also included hospital random effects.