The inpatient experience of emerging adults in the United States

ABSTRACT

Objectives

Emerging adults transitioning from pediatric to adult care experience worse outcomes including increased mortality. Improved patient experience (PEX) correlates with decreased inpatient mortality and better adherence to quality guidelines. We aimed to evaluate trends in the PEX of inpatients aged 14–29 years in the United States (US).

Methods

We performed a retrospective cohort study using a national, de-identified PEX survey obtained from hospitalized patients aged 14–29 years between 2017 and 2019. We described and compared survey responses across 10 domains. Composite mean scores for each health facility were converted to percentile rankings, which were then compared by age group to determine differences in percentile ranking (ΔPR).

Results

We evaluated the results of 174,174 PEX surveys across a national sample of 1519 US hospitals. The PEX percentile rankings for ages 18–21 were lower than ages 14–17 in almost every domain including experience with nurses (ΔPR = 43.4, p < 0.001), physicians (ΔPR = 31.1, p < 0.001), treatment (ΔPR = 12.3, p < 0.001), and overall experience (ΔPR = 26.5, p < 0.001). Similarly, 22–25-year-olds reported a worse PEX across nearly all domains when compared to 26–29-year-olds.

Conclusion

In a national sample of PEX surveys, hospitalized emerging adults aged 18–25 reported worse PEX when compared to both older children and established adults. These lower ratings were most strongly attributed to people, processes, and relationships as opposed to differences in the hospital environment. By ages 26–29, PEX returned to levels similar to those reported by ages 14–17. These results suggest that further investigation to elucidate the unique needs of hospitalized emerging adults may be warranted.

KEYWORDS:

• Patient experience
• emerging adulthood
• established adulthood
• adolescence
• young adult
• press ganey
• patient-physician relationship
• patient-nurse relationship
• hospital environment
• transition medicine

Acknowledgments

We would like to thank Press Ganey LLC for providing the data used in this study. We would also like to thank all patients who completed the Press Ganey survey.

Disclosure of any financial/other conflicts of interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. One peer reviewer discloses that they are a practicing neurologist and also Chief Medical Officer for Qualtrics, a PG competitor.

Other peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author participation

All authors had access to the data and a role in writing the manuscript.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/21548331.2022.2129176

Additional information

Funding

The authors have no funding to report.