Nonresponse Bias on Inpatient Rehabilitation Hospitals’ Experience of Care Quality Measure Scores
Archives of Rehabilitation Research and Clinical Translation, 2024 · DOI: https://doi.org/10.1016/j.arrct.2024.100363 · Published: January 1, 2024
Simple Explanation
Inpatient rehabilitation facilities (IRFs) aim to help patients with major illnesses or injuries regain functional abilities and participate in their communities. Understanding nonresponse bias is crucial when assessing IRF quality, as neurologic conditions can affect a patient's ability to respond to surveys. This study compares data from routine IRF surveys and research project surveys to evaluate the representativeness of survey respondents and the impact of proxy responses.
Key Findings
- 1IRF Survey respondents had higher cognitive function than nonrespondents; patients with spinal cord injuries were more likely to complete the IRF Survey than other patients.
- 2There were subtle differences in quality measure results across surveys, reflecting the extent to which patients are encouraged to complete experience of care surveys.
- 3Agreement was higher on questions about global hospital perceptions than specific aspects of patients’ experience.
Research Summary
Practical Implications
Quality Measure Development
Consider variables associated with top-box variations as risk adjusters when developing quality measures for IRFs.
Improved Response Rates
Efforts to improve response rates will result in quality measure results that are more generalizable to IRFs’ entire patient populations; they also may be less favorable.
Future Research
Future research should collect data from a larger sample of IRFs and simultaneously collect responses from patients and their proxies.
Study Limitations
- 1Sample data were collected from 2 IRFs in the Midwestern United States and are not representative of all IRFs.
- 2Questions were similar but not identical in the Research Survey and the IRF Survey, and rating scales were not the same.
- 3We do not know to what extent proxy respondents obtained patient input to provide answers to survey questions.