Experience Of Inpatient Care Research Articles

Experiences of Inpatient Healthcare Services Among Children With Medical Complexity and Their Families: A Scoping Review.

Children with medical complexity (CMC) have high healthcare utilization and face unique challenges during hospital admissions. The evidence describing their experiences of inpatient care is distributed across disciplines. The aim of this scoping review was to map the evidence related to the inpatient experience of care for CMC and their families, particularly related to key aspects and methodological approaches, and identify gaps that warrant further study. This scoping review was conducted in accordance with JBI methodology and included all studies that reported experiences of acute hospital care for CMC/families. All study designs were included. Databases searched included EMBASE, CINAHL Plus with Full Text, Web of Science, MEDLINE(R) and APA PsycInfo from 2000 to 2022. Details about the participants, concepts, study methods and key findings were abstracted using a data abstraction tool. A thematic analysis was conducted. Forty-nine papers were included: 27 qualitative studies, 10 quantitative studies, six mixed methods studies, two descriptive studies and four reviews. Some quantitative studies used validated instruments to measure experience of care, but many used non-validated surveys. There were a few interventional studies with a small sample size. Results of thematic analysis described the importance of negotiating care roles, shared decision-making, common goal setting, relationship-building, communication, sharing expertise and the hospital setting itself. CMC and families value relational elements of care and partnering through sharing expertise, decision-making and collaborative goal-setting when admitted to hospital. This review was conducted in alignment with the principles of patient and family engagement. The review was conceptualized, co-designed and conducted with the full engagement of the project's parent-partner. This team member was involved in all stages from constructing the review question, to developing the protocol, screening articles and drafting this manuscript.

Behaviour Concerns in Preschool Cardiac Surgery Survivors

BackgroundBehaviour concerns (BC) are reported in survivors of complex cardiac surgery (CCSx) with inconsistent evidence about health and demographic variables that impact outcomes. MethodsA prospective inception-cohort study of infants (without known chromosomal abnormalities) after CCSx from 2001 to 2017 determined Behaviour Assessment System for Children (BASC-II/III) parent rating scales at 4.5 years. T scores ≥60 for externalizing, internalizing, and the Behavioural Symptoms Index and ≤40 for adaptive behaviour defined BC. Potential predictive variables included demographic, acute care, and health factors after initial CCSx. Multiple logistic regression using the purposeful selection method gave odds ratios (ORs) with 95% confidence intervals (CIs). ResultsSurvivors (n = 585; 61% boys, 40% single ventricle) were assessed at a median age of 55 months (interquartile range: 53, 57 months). Independent predictors were noncardiac hospitalizations (OR: 1.10, 95% CI: 1.02, 1.19; P = 0.015) for externalizing; noncardiac hospitalizations (OR: 1.14, 95% CI: 1.05, 1.24; P = 0.003), female sex (OR: 1.62, 95% CI: 1.04, 2.52; P = 0.031), and single ventricle (OR: 1.82, 95% CI: 1.04, 3.17; P = 0.035) for internalizing; noncardiac hospitalizations (OR: 1.10, 95% CI: 1.02, 1.19; P = 0.017), socioeconomic status (SES) (OR: 0.98, 95% CI: 0.96, 0.10; P = 0.031), and years of maternal schooling (OR: 0.91, 95% CI: 0.84, 0.10; P = 0.04) for adaptive; and extracorporeal life-saving support (OR: 2.03, 95% CI: 1.01, 3.96; P = 0.041) for the Behavioural Symptoms Index, indicating more pervasive behaviours. ConclusionsThe number of noncardiac hospitalizations predicted increased odds of BC and requires further attention. Improving inpatient trauma-informed care experiences and optimizing access to primary care to prevent noncardiac hospitalization may be modifiable.

Developing and exploring the validity of a patient reported experience measure for adult inpatient diabetes care.

To develop and explore the validity of a Patient Reported Experience Measure (PREM) for adult inpatient diabetes care. 27 in-depth interviews were conducted to inform the development of the 42-item PREM which was cognitively tested with 10 people. A refined 38-item PREM was piloted with 228 respondents completing a paper (n = 198) or online (n = 30) version. The performance of the PREM was evaluated by exploring (i) uptake/number of responses and (ii) survey validity by investigating whether the PREM data were of adequate quality and delivered useful information. The PREM had low drop-out or missing data rates suggesting it was appropriately constructed. Analysis of item frequencies and variances, and problem score calculations concluded that questions provided sufficient score differentiation. This new PREM allows for experiences of inpatient diabetes care to be measured, understood and reported on to help identify priority areas for improving care quality.

The effectiveness of a government-sponsored health protection scheme in reducing financial risks for the below-poverty-line population in Bangladesh.

The Government of Bangladesh is piloting a non-contributory health protection scheme called Shasthyo Surokhsha Karmasuchi (SSK) to increase access to quality essential healthcare services for the below-poverty-line (BPL) population. This paper assesses the effect of the SSK scheme on out-of-pocket expenditure (OOPE) for healthcare, catastrophic health expenditure (CHE) and economic impoverishment of the enrolled population. A comparative cross-sectional study was conducted in Tangail District, where the SSK was implemented. From August 2019 to March 2020, a total of 2315 BPL households (HHs) (1170 intervention and 1145 comparison) that had at least one individual with inpatient care experience in the last 12 months were surveyed. A household is said to have incurred CHE if their OOPE for healthcare exceeds the total (or non-food) HH's expenditure threshold. Multiple regression analysis was performed using OOPE, incidence of CHE and impoverishment as dependent variables and SSK membership status, actual BPL status and benefits use status as the main explanatory variables. Overall, the OOPE was significantly lower (P < 0.01) in the intervention areas (Bangladeshi Taka (BDT) 23 366) compared with the comparison areas (BDT 24 757). Regression analysis revealed that the OOPE, CHE incidence at threshold of 10% of total expenditure and 40% of non-food expenditure and impoverishment were 33% (P < 0.01), 46% (P < 0.01), 42% (P < 0.01) and 30% (P < 0.01) lower, respectively, in the intervention areas than in the comparison areas. Additionally, HHs that utilized SSK benefits experienced even lower OOPE by 92% (P < 0.01), CHE incidence at 10% and 40% threshold levels by 72% (P < 0.01) and 59% (P < 0.01), respectively, and impoverishment by 27% at 10% level of significance. These findings demonstrated the significant positive effect of the SSK in reducing financial burdens associated with healthcare utilization among the enrolled HHs. This illustrates the importance of the nationwide scaling up of the scheme in Bangladesh to reduce the undue financial risk of healthcare utilization for those in poverty.

Service User Experience of Receiving Remote Inpatient Mental Health Treatment via the Homecare Service

The Homecare Service was developed as a response to the COVID-19 pandemic, providing all the elements of a mental health inpatient programme remotely, in the comfort and safety of the service user’s home thus reducing the need for a physical admission. The aim of this study was to explore service user experiences of a remote virtual inpatient care at an Irish independent mental health service. All participants who had a virtual admission in a 3-month period were invited to complete a series of questions via an online survey. Three open-ended questions generated qualitative data from this mixed methods study, which were thematically analysed. Three themes reflected service user experience: ‘The Homecare Service: a viable alternative to inpatient care’; ‘Importance of relationships’ and ‘Technology and Homecare.’ Overall, there was general satisfaction with the service. This study provided a good opportunity to identify issues that have emerged considering the prompt implementation of the initiative. Feedback relating to improvements can be implemented in future service delivery.

Effect of no cost sharing for paediatric care on healthcare usage by household income levels: regression discontinuity design

ObjectivesTo investigate the impact of no cost sharing on paediatric care on usage and health outcomes, and whether the effect varies by household income levels.DesignRegression discontinuity design.SettingNationwide medical claims database...

Patients’ experiences of forensic mental health inpatient care: a systematic review and thematic synthesis of qualitative literature

PurposeThe purpose of this paper is to develop an understanding of the experience of secure care from the patients’ perspective.Design/methodology/approachA systematic review of qualitative literature was conducted. The data was sourced from the electronic databases: PsychINFO, CINAHL, Medline and the Web of Science Core Collection using pre-defined search terms. A total of 17 studies, conducted in various countries worldwide and covering high, medium and low secure inpatient settings, were included for review. The analysis involved integrating findings from across the literature and was guided by thematic synthesis.FindingsA total of eight themes were generated from the data, three of which provided an understanding of the experience of forensic secure care, and the remaining five themes provided an understanding of the factors which may influence the experience of secure care.Practical implicationsDeveloping understanding of patient experience can lead to service improvements, potentially impacting patients’ motivation and engagement and thus reducing admission times, potential recalls and recidivism.Originality/valueTo the best of the authors’ knowledge, this is the first systematic review to date to exclusively explore the broad topic of the patient experience of secure mental health care.

Pediatric Inpatient Leaders, Views Changed with COVID-19: A Call to Re-engage in Quality Improvement.

Pediatric Inpatient Leaders, Views Changed with COVID-19: A Call to Re-engage in Quality Improvement.

Determinants of clinical outcome and length of stay in acute care forensic psychiatry units

Criminological and sociodemographic variables, such as previous criminal convictions, increased risk of violence, early onset of mental disorder, antisocial personality, psychosis and low social support, have all been related to longer length of stay (LoS) and poorer outcome in long stay forensic services. The factors impacting on LoS and clinical response in acute care specialized units are poorly documented. To address this issue, we examined the psychiatric records of all cases admitted between January 1st and December 31th 2020 in the sole acute ward for detained persons located in the central prison of the Geneva County, Switzerland. Information on judicial status included pre-trial versus sentence execution, previous incarcerations, and age of the first incarceration. Sociodemographic data included age, gender, marital status, and education attainment. Previous inpatient stays prior to incarceration were recorded. All of the ICD-10 clinical diagnoses were made by two independent, board-certified psychiatrists blind to the scope of the study. The standardized assessment was based on the HoNOS (Health of Nation Outcome Scales) at admission and discharge, HONOS-secure at admission, HCR-20 (Historical Clinical Risk 20) version 2, PCL-R (Psychopathy Checklist Revised), and SAPROF (Structured Assessment of Protective Factors). Stepwise forward multiple linear regression models predicting the LoS and delta HONOS respectively were built with the above mentioned parameters. The selected variables were then used in univariate and multivariable regression models. Higher HCR-scores (mainly on clinical items), and longer LoS were related to higher delta HONOS scores. In contrast, cases in pre-trial detention showed a worst clinical outcome. In multivariable models, all three variables remained independent predictors of the clinical outcome and explained 30.7% of its variance. Only education and diagnosis of borderline personality were related to the LoS and explained 12.6% of its variance in multivariable models. Our results suggest that the use of acute wards specialized in forensic psychiatry are mainly useful for patients with prior inpatient care experience, and higher violence risk during sentence execution. In contrast, they seem to be less performant for persons in pre-trial detention that could benefit from less restrictive clinical settings.

Changing bodies: A scoping review and thematic analysis of family experience during serious childhood illness.

This scoping review has investigated experiences of children and parents encountering in-patient treatment for serious childhood illness, including current or potential use of technology as a support mechanism. The research questions were 1. What do children experience during illness and treatment? 2. What do parents experience when their child is seriously ill in hospital? 3. What tech and non-tech interventions support children's experience of in-patient care? The research team identified n = 22 relevant studies for review through JSTOR, Web of Science, SCOPUS and Science Direct. A thematic analysis of reviewed studies identified three key themes reflecting our research questions: Children in hospital, Parents and their children, and Information and technology. Our findings reflect that information giving, kindness and play are central in hospital experiences. Parent and child needs in hospital are interwoven and under researched. Children reveal themselves as active producers of pseudo-safe spaces who continue to prioritise normal child and adolescent experiences during in-patient care.

Conducting Women’s Groups in the Inpatient Unit: Empowering a High-Risk Population by Preventing Unplanned Pregnancies

AbstractIntroductionWomen with mental illness are 5x more likely to experience an unplanned pregnancy due to lower rates of effective contraception use; they also experience higher rates of adverse pregnancy outcomes. Education about women’s reproductive health and family planning are not routinely offered in inpatient mental health and addiction treatment settings.MethodsWeekly women’s groups on the inpatient psychiatry unit were led by psychiatry residents who were trained and provided a script. Groups focused on structured contraception education followed by an open-discussion format.Data collected included the percentage of women with history of contraception use, child protective service involvement, unplanned pregnancies, abortions, and percentage of women who found the group helpful. Special care was taken to discuss contraception as a tool for empowering women to make their own decisions about their contraceptive needs.ResultsThirteen sessions were conducted, and attendance among women on the inpatient unit was 42%. Out of the 32 patients who participated, 100% found the group beneficial and responded they would share information they learned with women outside the group. 26.4% self-identified as using contraception, 50% had unplanned pregnancy, 23.6% have had an abortion, and 26.4% have had child protective services involvement.Dissemination of contraceptive information in these women’s groups effectively led women to consider options that were available to them and seek contraceptive methods that were appropriate to their situation. Women reported they gained a better understanding of the medical, emotional, and financial implications of unplanned pregnancies. The groups were conducted in an open-discussion format that allowed women to participate in shared experiences; in many cases, the discussions were therapeutic. Feedback from patients and unit staff was positive. Many patients requested further groups to discuss issues women face, such as domestic violence and experiences as a mother.ConclusionsConducting women’s groups on the inpatient unit is critical in view of the poor access to healthcare that vulnerable women who seek inpatient psychiatric care experience. The groups on the inpatient unit are unique because it is often the only time these women have an opportunity for crucial, gender-specific preventative healthcare. These groups should further lead to appropriate referral and follow-up with primary care or women’s clinic providers.Ongoing efforts will be put forth to increase group attendance, to incorporate participation from unit staff, and to build this group into a resident curriculum for group therapy.FundingNo Funding

Family experiences of inpatient mental health care for people with dementia.

This study investigates family carers experiences of inpatient mental health care for people with dementia. A mental health inpatient admission for a person with dementia is usually considered when a person is distressed and this distress leads to behaviours that are assessed to be risky for the person or others. Participants included seven family carers whose relative with dementia had been cared for within a mental health ward in the United Kingdom UK within the last 5 years. Interviews were used to explore the circumstances that led to the admission, expectations of mental health care, and perceptions of care during the admission and support received by family carers. Participants described their distress at the time of admission and how the process of admission sometimes added to their distress. Carers often felt excluded from their relatives care in hospital and many felt a loss of their rights. Participants felt that the mental health admission had a negative impact on their relative with dementia. Mental health law and legislation was difficult to navigate and carers were concerned about how much knowledge and understanding of dementia staff have. Findings suggest that family carers may benefit from targeted support during their relatives admission. Mental health wards could do more to recognise the expertise in care and knowledge of the person with dementia of family carers and involve them in planning care. More research is needed to explore the experiences and outcomes of people with dementia during such admissions.

Case-mix adjustment of patient-reported experience measures in National Regional Center for Pediatric.

The aim of the study was to identify case-mix adjusters for the Chinese version of the Child Hospital Consumer Assessment of Healthcare Providers and Systems (Child-HCAHPS) and assess the impact of case-mix adjustment on patient experience measures in China. This study analyzed data collected from six National Regional Center for Pediatric across China retrospectively. Participants were children aged ≤17 years and their guardians who completed the survey. The Chinese Child-HCAHPS was used to measure pediatric inpatient care experience. Candidate case-mix adjusters were assessed using a summary measure of explanatory power. Changes in scores and rankings of the six centers were quantified to assess the impact of adjustment. A total of 2708 respondents completed the survey from January to March 2021, with a response rate of 7-15%. The child's global health status and the respondent being the child's mother were identified as case-mix adjusters, and case-mix adjustment models for 18 patient experience items were constructed. Kendall's τ correlation of hospital rankings before and after adjustment ranged from 0.73 to 1.00. Although the impact of case-mix adjustment may appear modest in our sample, it demonstrated the feasibility, necessity, and methodology for further development of case-mix adjustment models in pediatric healthcare facilities in China. Case-mix adjustment models adjust for factors that are unamendable by healthcare providers that may affect patient experience ratings, thereby improving the comparability of institutional-level ratings. Standardized case-mix adjustment protocols for quality measures need to be modified in different settings. This is the first study to identify adjustment variables and the possible impact of case-mix adjustment on pediatric inpatients' experience measures in a Chinese population. This study provided evidence on the feasibility and necessity for further development of case-mix adjustment models for pediatric healthcare facilities in China.

Recommendations for Minimum Residency Training Requirements in Pediatric Hospital Medicine.

Recommendations for Minimum Residency Training Requirements in Pediatric Hospital Medicine.

Emphasising Organisational Routine: A Qualitative Study of Patient and Health Professional Experiences of Inpatient Oncology Care

Although the experience of hospitalisation for cancer management has been widely researched, such research from the African sub-continent is limited. This study explored experiences of patient care in a tertiary, inpatient oncology setting in urban South Africa, from the point of view of patients and health professionals. In-depth interviews and focus groups were conducted with participants. Participants included oncology inpatients, oncologists, nurses and nursing management (N = 46) at an oncology unit in Johannesburg, South Africa. Data were analysed by a multidisciplinary research group using reflexive thematic analysis principles. Our results suggest that barriers to establishing effective organisational routines included communication breakdowns between patients and healthcare providers, a lack of predictability in interactions with doctors, deficient access to information and diminished confidence in nurses. Oncology inpatients may not feel in control of their circumstances, in part due to lacking routine in the hospital setting. Ironically, nurses, who are often at the frontline of patient management, appear to be underutilised or disabled by the healthcare system as conveyors of information. Robust organisational routines for oncology inpatients may be a good mechanism for allaying uncertainty and conferring a sense of control. Nursing staff, as the individuals with the most direct patient contact, could be instrumental in nurturing organisational routines towards improving patient perceptions of care.

Development of the Australian hospital patient experience question set for parents

<h2>ABSTRACT</h2><h3>Background</h3> The Australian Commission on Safety and Quality in Health Care developed the Australian Hospital Patient Experience Question Set to ask adult patients about their experience of inpatient care. This question set was not validated for paediatric care. <h3>Aim</h3> To adapt and validate the Australian Hospital Patient Experience Question Set for parents and carers of children who received inpatient care. <h3>Methods</h3> Interviews with fourteen parents and carers were conducted. Content analysis was used to revise the question set and to identify experience specific to children and parents. The Question Set was revised, including three new questions to reflect parent experience. Content validity of each new question was assessed. Data was split and construct validity assessed using exploratory and confirmatory factor analysis (n=1500). <h3>Findings</h3> Two main qualitative categories of care included ‘parent experience' and ‘children being heard'. Emotional support was an integral aspect of parent experience. The revised question set (13-question, one-factor model of good fit) demonstrated construct validity (n=500: Root Mean Square Error of Approximation=0.042, Confirmatory Fit Index=0.997, Tucker Lewis Index=0.996, Composite reliability=0.962). <h3>Discussion</h3> This study adds empirical support for a common measurement framework for experience of care in children's health services. Parents spoke of the value of having a parent and a child reported survey. The next step is for children to report on their own experience. <h3>Conclusion</h3> The revised (parent-reported) question set provides a validated tool which reflects the unique experience of parents and facilitates consistent monitoring and improvement of patient experience in a paediatric inpatient setting.

Patient Experience of Inpatient Care and Services Received at a Teaching Hospital in Malaysia: A Cross-Sectional Study

Background: Patients’ experience reflects the quality of healthcare services from the end user’s perspective and therefore is an essential indicator of healthcare quality. This study aimed to measure patient experience of inpatient care and services received at a teaching hospital. Methods: A total of 321 patients were enrolled in this quantitative, cross-sectional study during their discharge. Data were collected from May to September 2018 through a validated self-administered questionnaire adapted from the Hospital Consumer Assessment of Healthcare Providers and Systems survey. Analysis of patient experience and overall hospital quality rating was conducted using SPSS version 25. Results: The majority of the patients (91%) reported a positive experience of inpatient care and perceived a high quality of service provided by the hospital. Further analysis revealed that the patients’ experiences varied significantly with their age, ethnicity, religion, employment status, type of ward, and perceived health status (all p < 0.05). Meanwhile, the level of patient experience was significantly correlated with the overall rating of the hospital (r = 0.804, p < 0.001). Conclusions: The findings served as benchmark data for hospital management to address issues related to hospital services. Future studies should be extended to patients from multidisciplinary wards and outpatient units to provide a significant reflection of hospital service quality.

"My life isn't my life, it's the systems": A qualitative exploration of women's experiences of day-to-day restrictive practices as inpatients.

WHAT IS KNOWN ON THE SUBJECT?: Sometimes someone needs to be in hospital because they are struggling with their mental health and need some extra support but being in hospital can also be a difficult experience. There are a lot of restrictions in place in hospital, like locked doors, rules to follow and not much choice about what happens to you. Other research has found that these restrictions can feel difficult and stressful for people and so more research is needed about this. We wanted to know what being in hospital felt like for women in particular. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: We interviewed women who were in hospital because of their mental health about what it was like for them in hospital. The women told us that they felt powerless while they were in hospital. They sometimes felt like they were being punished and this could affect their mood and could lead to them hurting themselves. They also said that they were not always listened to by staff, and they found it difficult being away from their family and friends while they were in hospital. The women also told us that being in hospital could sometimes help them to feel safe. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Women should be looked after in hospital in a way that helps them to feel in control of what happens to them. They should be supported to be able to go outside the hospital on leave, to keep in touch with their family and friends, and they should be listened to by staff. A project called "safewards" has suggested some ways for helping to make hospital wards safer. They have suggested that everyone should be clear about what the rules are when they go into hospital and ways that staff could communicate more clearly with the people they are working with. Our research supports using these techniques. ABSTRACT: Introduction Inpatient care often involves restrictive interventions such as seclusion and restraint and restrictive practices that limit the person's freedom, rights and daily activities. Restrictive practice has not been the explicit focus in previous research; however, it often appears as an important theme, with participants identifying it can have a detrimental effect on their well-being. More research specifically on this topic in an inpatient setting is, therefore, needed. Women might be particularly vulnerable to adverse effects of restrictive practices compared to men as women generally occupy less powerful positions in society and more often experience abuse. Aims The study aimed to explore women's experiences of routine restrictive practices in mental health inpatient settings. Methods Twenty-two women who were currently inpatients on mental health wards were interviewed about their experiences of restrictive practices in hospital. Interviews were analysed using thematic analysis. Results An overarching theme emerged of powerlessness. Four key sub-themes were also identified: restrictions perceived as punitive, having no voice, impact of restrictions on relationships and restrictions providing safety and support. Discussion Although restrictive practices were found to provide the women with a sense of safety, they were also found to impact upon the women's well-being, leading to increases in self-harm and over-reliance on restrictions. Implications for practice This research highlights the importance of gender-informed inpatient services for women that foster independence, empowerment and allow women to have their voices heard. Safewards interventions such as clear mutual expectations and soft words could contribute to mitigating the impact of restrictive practices.

Delivering Trauma-Informed Care in a Hospital Ward for Older Adults With Dementia: An Illustrative Case Series.

IntroductionUp to 70% of older adults have experienced a psychologically traumatic event in their life. Traumatic events can have lifelong effects on functioning and emotion regulation and can affect behavior and experiences in care settings. Common healthcare practices and environments can be re-traumatizing for trauma survivors. These features may trigger behavior change (e.g., aggression and agitation) particularly after the onset of dementia. However, very little research exists to understand how the effects of traumatic events manifest in aged care settings. Trauma-informed care is a framework in which the potential impact of trauma is acknowledged, and practices and procedures are adapted to maximize feelings of control and safety for the patient. Trauma-informed care is an innovative approach with little published evidence in acute geriatric settings.MethodsWe present a series of cases to demonstrate how psychological trauma can affect the experience of inpatient care for older people. The cases detail the patients' relevant background, triggers and behaviors followed by the steps taken by staff to support the patient and respond to their trauma-related needs. These cases describe how the principles of trauma-informed care can be applied to recognize when past psychologically traumatic events are impacting the older adult in hospital. The outcomes of these interventions are reported on in terms of their impact on challenging behavior, patient experiences and satisfaction with care, and/or staff confidence and skill.FindingsA range of past events negatively impacted the patients during their time in hospital, including childhood abuse, military service, and domestic violence. Staff implemented strategies to accommodate trauma-related needs while providing care that improved safety and reduced patient distress. Principles of trauma-informed care were applied where able, including providing choices and enabling autonomy. However, organizational and environmental features of inpatient wards continued to pose risks for re-traumatisation.ConclusionsTrauma-informed care is an under-utilized yet potentially beneficial approach to care for older adults in the hospital setting. The cases detailed here demonstrated that the impact of psychological trauma requires an individualized response from staff which when effectively implemented can promote staff and patient safety, reduce the risk of re-traumatisation, and minimize adverse events.

Inpatient opioid receipt and care experiences for vaginal delivery.

To examine the relationship between care experiences and inpatient opioid receipt during and after delivery for women hospitalized for vaginal delivery (VD). We used a pooled cross-sectional design with inverse probability weighting to examine the association between inpatient opioid receipt and care experiences of women hospitalized for VD at a single health care system in a Midwestern state. We used 4 Hospital Consumer Assessment of Healthcare Providers and Systems scores (2 pain care items and 2 global items) as measures of care experiences of women hospitalized for VD. We used 4 inverse probability-weighted logit regressions to estimate the relationship between inpatient opioid receipt and each patient care experience measure. In supplementary analyses, we used the same inverse probability-weighted methods to estimate the relationship between receipt of opioids and patient care experience measures in 3 patient subgroups based on mean patient-reported pain score during hospitalization (no pain, mild pain, moderate pain). We found no relationship between inpatient opioid receipt and inpatient pain care experiences. As an exception, we found that women hospitalized for VD were 5 (95% CI, 2-8) percentage points more likely to rate the hospital as 10 ("the best hospital possible") during hospitalizations in which an opioid was received. We also found higher overall ratings of the hospital among hospitalized women who reported mild pain if they received an opioid (marginal effects = 0.05; 95% CI, 2-8 percentage points). Receipt of opioids may not be a significant determinant of the pain-specific patient care experiences of women hospitalized for VD.