Quality of communication about medicines in United States hospitals: A national retrospective study

•A first national retrospective study on “Communication about Medicines” (ComMed) in U.S. Hospitals.•Centers for Medicare and Medicaid public Hospital Consumer Assessment of Healthcare Providers and Systems data were used.•Study found U.S. hospitals' ComMed quality significantly varied by region, rurality, and health information technology (HIT) infrastructure.•Geographic and HIT infrastructure factors related to hospital ComMed quality warrant stakeholders' attention.•Study's findings can serve as baseline data to help the design of future interventions to improve patients' star ratings of hospitals' ComMed quality.•Study suggests opportunities for hospitals to involve pharmacists and use HIT infrastructure to efficiently enhance ComMed quality to patients.

BackgroundDespite the benefits of improving transitions across care, literature is very limited on inpatient “Communication about Medicines” (ComMed) by staff across United States (U.S.) hospitals.ObjectivesTo evaluate ComMed quality variations by hospital characteristics.MethodsIn a cross-sectional, retrospective study of publicly available U.S. Medicare's Hospital Consumer Assessment of Health Care Plans Survey (HCAHPS) data (January 2013-September 2014), ComMed quality (high = above average/excellent vs. low = average/below average/poor star ratings) of 3125 hospitals were compared across region, rural-urban location, and health information technology (HIT) infrastructure giving providers access to patients' electronic medical records. Multivariate logistic regression analysis was conducted with adjusting for confounders (hospital - bed size, ownership, type, ED services, the number of completed HCAHPS surveys).ResultsAfter adjusting for other characteristics, Midwest versus Western region hospitals (OR = 1.55, 95% CI: 1.21-1.98, p=<0.0001), hospitals with HIT infrastructure (OR = 1.29, 95% CI: 1.05-1.59, p = 0.02) were more likely while Northeast vs. Western region hospitals (OR = 0.67, 95% CI: 0.50-0.89, p=<0.0001) and hospitals in metropolitan areas with 1 million or more population vs. Nonmetro area with less than 2500 population were less likely (OR = 0.68, 95% CI: 0.48-0.95, p=<0.0001), to be associated with high ComMed quality. Hospitals' small bed-size, physician/non-profit ownership, critical-access type, absent ED services, and 100-299 HCAHPS completed surveys were more likely to be associated with high ComMed quality.ConclusionsOne of the first national studies found significant variations in ComMed quality across U.S. hospitals by location (high in Midwest and low in Northeast regions and urban areas) and by access to HIT infrastructure (high) after controlling for other hospital characteristics. With this baseline data, hospital providers and policymakers can design, implement, and evaluate service programs with pharmacists and HIT to enhance ComMed quality in the future delivery of patient-centered care.