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By Danell J. Haines, PhD
The trend of improved overall home and specialty infusion patient satisfaction continues, evident by 5 years of National Home Infusion Foundation (NHIF) Patient Satisfaction Survey data. Prior to the development of the NHIF Benchmarking Program, patient satisfaction surveys as one measure of provider quality had been used in the home and specialty infusion industry for many years, driven in part by accreditation standards and by the value derived from regularly assessing one’s company service from the patient’s perspective. Home infusion providers realize that the quality of home and specialty infusion services is essential for meeting the patients’ needs and expectations in an ever-changing and improving health care system. The NHIF Patient Satisfaction validated survey tool was initiated based on a need for standardization among the patient satisfaction survey questions used by the home and specialty infusion provider locations so that industry-wide analysis and comparisons could be conducted.1,2
Since 2019, NHIF has collected satisfaction data from 43,174 home and specialty infusion patients.
In 2017, NHIF took the lead in the development of the Uniform Patient Satisfaction Survey for Home Infusion Providers.1 Using Delphi methodology, survey questions and response options were written using a 15-member home infusion expert panel to validate and establish consensus for the questions. The panel was asked to rate, modify, and add patient satisfaction questions during 3 iterations and reviews. The validated survey questions were pilot tested and included a phone interview with patients who completed the survey. This determined the clarity of the questions and subsequent internal validity. Modifications were made based on feedback from the patients. The final survey that is used by NHIF includes 12 questions with 22 data points.1
Home and specialty infusion providers using the validated and standardized NHIF Patient Satisfaction Survey have had the opportunity to provide their survey data to NHIF for the benchmarking program. To ensure that provider data was deidentified and confidentiality was maintained, NHIF partnered with Strategic Healthcare Programs (SHP) to serve as a data intermediary and recipient of returned surveys and/or survey data files. The Patient Satisfaction Survey was either administered by mail by SHP or by the individual home and specialty provider via mail, phone, or electronically. Upon receiving the completed survey, SHP entered the data into an Excel file with no attached patient identifiers. All data provided to NHIF is uploaded to a secure data portal using a data participation code. Providers who submit at least 15 surveys quarterly receive an individualized Provider Patient Satisfaction Survey Report showing their top box percent, top box ranges, composite scores, and benchmarks. Each participating provider is aware of their company’s strengths and possible weaknesses and can use this information when setting provider location goals.
Since 2019, NHIF has collected satisfaction data from 43,174 home and specialty infusion patients. Survey data submitted to NHIF annually totaled 6,353 in 2019, 7,381 in 2020, 6,126 in 2021, 6,842 in 2022, and 16,472 in 2023. The 2 most recognized questions in health care patient satisfaction surveys are questions 11 and 12 on the NHIF survey and include, “I was satisfied with the overall quality of the services provided” and “I would recommend this company to my family and friends.” Patients used a Strongly Agree/Disagree 5-point Likert scale to rate their agreement to these statements. The percentage of patients that Strongly Agreed with the statements was calculated. Since “Strongly Agree” is the highest rating it is also referred to as the top box. The annual results (2019-2023) along with a trend line for these questions is shown in Table 1 and 2.
Evident by the trend line in Table 1, there has been a steady overall improvement in patient satisfaction since the introduction of the benchmarking program. The lowest annual top box percentage was in the first year, 2019 while the highest was in 2023. It is surmised that participating providers, who receive individualized quarterly reports, made quality improvements to rectify deficiencies. As a result, overall patient satisfaction improved.
Patient satisfaction with home infusion services reaches an all-time high in 2023. Satisfied patients are likely a contributing factor for the increased utilization of home infusion over the last decade, in addition to other benefits such as improved quality of life and lower costs for health plans.
“Willingness to recommend” is another metric that measures overall patient satisfaction. The 5-year annual results from question 12 of the survey is shown in Table 2. This question assumes that when a patient is satisfied with a provider, he or she might recommend it to family and friends. Like “Overall Patient Satisfaction,” the lowest percentage was observed in 2019 and highest in 2023. The trend line shows an overall increase in scores over 5 years.
It is interesting to note that for both questions 11 and 12 of the survey, positive patient responses included both Strongly Agree and Agree. The percentages shown in Table 1 and 2 are only the “Strongly Agree” patient responses. When the percentages for these 2 responses are added together, the annual averages would be 95% to 97%. It can be inferred from the scores from the 2 questions that home infusion patients are extremely satisfied with their overall patient experience which encompasses a diverse mix of health care professionals, staff, and contracted personnel.
Results from the analysis of 5 years of NHIF Patient Satisfaction Survey data for Question 11 and 12 show high rates of patient satisfaction. Satisfied patients are likely a contributing factor for the increased utilization of home infusion over the last decade, in addition to other benefits such as improved quality of life and lower costs for health plans. Having validated data to understand how patients perceive home infusion services benefits providers, prescribers, payors, and regulators as they evaluate how to apply home-based services.
1. Sullivan C, Haines DJ. Uniform Patient Satisfaction Purvey Questions for Home Infusion Providers. INFUSION. 2017; 23(2):29-36.
2. Sullivan C, Haines DJ. Setting the bar – establishing industry standards through benchmarking. INFUSION. 2018; 24(4): 26-33.
Danell J. Haines, PhD is President of D. J. Haines Research Consulting and the Statistical and Research Editor for Infusion Journal. She can be reached at Danell.Haines@NHIA.org
The NHIF Benchmarking Program is supported by Brightree.