Adults' comments on patient experience surveys explain variation in provider ratings, with negative comments providing more actionable information than positive comments. We investigate if narrative comments on the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey of inpatient pediatric care (Child HCAHPS) account for global perceptions of the hospital beyond that explained by reports about specific aspects of care. We analyzed 545 comments from 927 Child HCAHPS surveys completed by parents and guardians of hospitalized children with at least a 24-h hospital stay from July 2017 to December 2020 at an urban children's hospital. Comments were coded for valence (positive/negative/mixed) and actionability and used to predict Overall Hospital Rating and Willingness to Recommend the Hospital along with Child HCAHPS composite scores. Comments were provided more often by White and more educated respondents. Negative comments and greater actionability of comments were significantly associated with Child HCAHPS global rating measures, controlling for responses to closed-ended questions, and child and respondent characteristics. Each explained an additional 8% of the variance in respondents' overall hospital ratings and an additional 5% in their willingness to recommend the hospital. Child HCAHPS narrative comment data provide significant additional information about what is important to parents and guardians during inpatient pediatric care beyond closed-ended composites. Quality improvement efforts should include a review of narrative comments alongside closed-ended responses to help identify ways to improve inpatient care experiences. To promote health equity, comments should be encouraged for racial-and-ethnic minority patients and those with less educational attainment.

中文翻译：

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关于儿科住院经历的叙述性评论提供了超出封闭式 CAHPS 调查问题答案的大量信息

成人对患者体验调查的评论解释了提供者评级的差异，负面评论比正面评论提供了更多可操作的信息。我们调查了对住院儿科护理 (Child HCAHPS) 的医疗保健提供者和系统消费者评估 (CAHPS®) 调查的叙述性评论是否可以解释除有关特定护理方面的报告所解释之外的全球对医院的看法。我们分析了 2017 年 7 月至 2020 年 12 月期间在城市儿童医院住院至少 24 小时的住院儿童的家长和监护人完成的 927 份儿童 HCAHPS 调查中的 545 条评论。评论按效价（正/负/混合）和可操作性进行编码，并用于预测总体医院评级和推荐医院的意愿以及儿童 HCAHPS 综合评分。白人和受过更多教育的受访者更常发表评论。负面评论和评论的更大可操作性与儿童 HCAHPS 全球评级措施显着相关，控制对封闭式问题的回答以及儿童和受访者的特征。每个人都解释了受访者总体医院评级中额外 8% 的差异以及他们推荐医院意愿的额外 5% 的差异。儿童 HCAHPS 叙述性评论数据提供了关于在住院儿科护理期间除封闭式复合之外对父母和监护人重要的重要信息。质量改进工作应包括对叙述性评论以及封闭式答复的审查，以帮助确定改善住院护理体验的方法。为了促进健康公平，应鼓励少数族裔患者和教育程度较低的患者发表评论。