Introduction There is growing emphasis on subjective care ratings as a tool to drive standards. The simple ‘Friends and Family Test’ is offered to all NHS inpatients after discharge. We included a selection of ‘rating’ style questions in the UK IBD audit inpatient experience survey.1This secondary analysis further evaluated patient factors associated with variation in ratings and explored their correlation with survey items asking about hospital experiences relevant to UK IBD Standards.
Method Responses to inpatient questionnaire (3rdround UK IBD audit) were analysed. Factors associated with overall rating (‘Rating’: ‘How would you rate the care you received?’) and the Friends and Family Test (‘FFT’: ‘Would you recommend this hospital to your friends and family?’) were explored: age, gender, disease type, admission type (emergency medical; emergency surgery; elective surgery) and health state at the time of questionnaire completion (EQ5D). 15 items were mapped onto specific IBD standards.
Results 2,067 respondents (UC 1,078, CD 989; 42.6% male; mean age 46.2 yrs; Elective surgery 20.7%, Emergency surgery 12.3%; 67.0% Medical therapy). Patients with CD had a lower QoL (EQ5D: UC 0.75 vs. CD 0.69, p < 0.001). Most patients (90.3%) reported good, v. good or excellent care; 90.4% of patients would probably or definitely recommend the hospital to friends and family. Increasing age correlated with better score (Rating: r = 0.136; FFT: r = 0.153). Mean scores of males higher than females (Rating: 4.17 vs. 3.92; FFT 2.58 vs. 2.43; p < 0.001), and UC patients answered more favourably (Rating: UC 4.09 vs. CD 3.96; FFT UC 2.52 vs. CD 2.47; p < 0.05). Emergency medical patients had least favourable responses. Better QoL correlated with Rating (r = 0.207) and FFT (r = 0.173). In multiple regression, independent variables predictive of Rating were EQ5D, age and gender, whereas for FFT the predictors were EQ5D, age, gender and type of admission. Correlation with 15 items linked to IBD standards varied from weak (Dietician Visit, r = 0.07) to moderately strong (‘Enough information to manage condition after discharge’, r = 0.50). In regression models adjusting for patient factors, only 5 of 15 questions were retained for ‘rating’ (r-sq: 0.47) and 4 for FFT (r-sq: 0.31).
Conclusion In IBD patients, ‘rating’ style questions are influenced by independent patient variables and current state of health and require careful interpretation. Correlation with questions relevant to IBD standards is variable, confirming that patient experience surveys should include items that map onto specific events and experiences rather than subjective ratings alone.
Disclosure of interest None Declared.
UK IBD Audit. National report of the results of the UK IBD audit 3rd round inpatient experience questionnaire responses. https://www.rcplondon.ac.uk/projects/ibdauditround3