Patients Rate Experience at California Hospitals in Eight Categories of Care

CalHospitals.org provides consumers with detailed ratings of 200 hospitals throughout state


The latest information on how patients perceive care at 200 California hospitals is now available online at CalHospitals.org. More than 36,000 people who spent at least one night in a participating hospital responded to the third statewide California hospital experience survey, sponsored by the California HealthCare Foundation (CHCF) and the California Institute for Health Systems Performance (CIHSP). Using the Web site, consumers can compare individual hospital results by region, county, city, or zip code. This year, for the first time, CalHospitals.org is also available in Spanish.

Statewide, about 24% of hospitals received an above-average rating for their overall performance. Fifty-one percent were rated as average and 25% below average.

California hospitals did well in three of eight areas surveyed: providing physical comfort, including pain medication; coordination of care while in the hospital; and respect for personal preferences.

Patients reported less favorable experiences in three areas: emotional support for their fears and anxieties while in the hospital; the “transition to home,” or what to expect after leaving the hospital, such as possible medication side effects and danger signs; and involvement of family and friends during hospitalization.

The number of California hospitals volunteering to participate in the study increased by 77% over the first survey in 2001. On average, the 200 participating hospitals care for more than 58% of patients discharged from California’s acute care hospitals. Six children’s hospitals participated.

“The patient experience survey is a unique opportunity for hospitals to work collaboratively and participate in the advancement of quality-of-care measurement,” said Mark D. Smith, M.D., M.B.A., president and CEO of the California HealthCare Foundation. “The survey provides comparable, standardized hospital patient data for medical, surgical, and maternity patients with the goal of improving patient care.”

Hospitals received a one- to three-star rating based on patients’ evaluations. The survey asked patients to assess their experience in eight categories: respect for patient preferences; coordination of care; information and education; physical comfort; emotional support; involvement of family and friends; transition to home; and, for the first time this year, experience with safe medical practices.

“One star is better than no stars,” said Lisa Payne Simon, senior program officer. “Hospitals involved in the survey are ahead of the game. They can use this information to jump-start quality improvements.”

“Recent research has established a strong link between patient experience and clinical outcomes,” said Marsha Nelson, president and CEO of CIHSP. “However, it should not be considered a guide to ‘good’ or ‘bad’ hospitals.”

Nelson emphasized that the patient experience survey does not evaluate a hospital’s clinical outcomes or the technical proficiency of its staff. “Consumers should use this information along with other indicators of quality before making a choice about where to get hospital care,” she said.

The survey is part of a growing movement to report performance of health care organizations publicly. The California survey is the largest scientifically valid survey of hospital patient experiences in the United States. It is based primarily on the Centers for Medicare and Medicaid Services national standard for measuring patient hospital experience, known as the Hospital-CAHPS survey. The California survey is the first Hospital-CAHPS pilot site to release results to the public.

Surveys were conducted by mail by The NRC+Picker Group. Between 300 and 600 medical, surgical, and maternity patients were randomly selected for each participating hospital. All of the patients spent at least one night in an acute-care hospital between November 1, 2003, and February 29, 2004. Individual hospital results were adjusted for patient health status, age, gender, and education.

Hospital-by-hospital results, along with their comments on performance improvement efforts, are at CalHospitals.org.

About CIHSP

CIHSP is an independent nonprofit corporation dedicated to improving health care in California and to increasing accountability of the provider community.


About the California Health Care Foundation

The California Health Care Foundation is dedicated to advancing meaningful, measurable improvements in the way the health care delivery system provides care to the people of California, particularly those with low incomes and those whose needs are not well served by the status quo. We work to ensure that people have access to the care they need, when they need it, at a price they can afford.