The dataset contains national and state-level results from 2013 to 2022 for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. The survey contains 19 core questions about critical aspects of patients’ hospital experiences (communication with nurses and doctors, the responsiveness of hospital staff, the cleanliness and quietness of the hospital environment, communication about medicines, discharge information, overall rating of hospital, and would they recommend the hospital). Patients’ answers were grouped into three categories, Top-box (Satisfied), Middle-box (Neutral), and Bottom-box (Dissatisfied).

The objective of the report is to evaluate whether the HCAHPS survey has been successful at incentivizing hospitals to improve their quality of care. I took the position that if hospitals were improving their quality of care, then the percentage of patients giving a top-box answer should increase over time.

To identify trends or patterns in data points, I used time plot series with linear regression trendlines for all measures. These trendlines indicated that Covid was a clear change point. Before Covid, the trend was positive. I then calculated the correlation coefficients between time and survey results for each measure for two periods: overall (2014–2022) and pre-Covid (2014–2020). Based on these correlation coefficients, I tested whether there was a significant moderate to strong positive correlation between time and top-box survey results for both time periods. The analysis concluded that with a 99% confidence level, the quality of care was improving over time before Covid. However, Covid was a change point that reversed this positive trend.

The next question was how significant those improvements were before Covid. By setting the positive change statistically significance threshold to greater than 5%, I calculated the rate of change of the linear regression trendline of time and national top-box percentage results. The conclusion of this analysis was that the positive trend before Covid was not significant.

The survey results measuring the quality of care were improving over time before Covid; however, these increases were not significant. Once Covid became a factor, these improvements were reversed. Therefore, it can be concluded that the survey has not resulted in significant improvement in patients’ reported quality of care.

When analyzing state-level survey results, the goal was to identify states that had performed significantly better than the national average and could be studied for effective strategies and best practices. Three categories were highlighted:

1. States that recorded an increase in their trendline pre-Covid of greater than 5%.
2. States with the highest overall hospital rating top-box scores.
3. States that reversed a negative Covid trend.

The report presents insights and visualizations in a concise one-page format. It also provides detailed analysis at both the national and state levels, along with an explanation of the data source.