In the United States, many surveys and data collection instruments have been developed for the hospital sector. These instruments provide valuable information to health managers and researchers by measuring different aspects of healthcare delivery across areas such as patient satisfaction, employee satisfaction, quality assessment, access to care, and performance measurement. Below is a set of summaries describing each survey type, what it is used for, and where the data can be accessed online.
Patient Satisfaction Surveys (HCAHPS and Others)
Surveys that measure patient satisfaction and experience play a critical role in evaluating hospitals’ patient-centered quality of care. The most widely used national survey is HCAHPS, the Hospital Consumer Assessment of Healthcare Providers and Systems. HCAHPS is the first national survey to measure patients’ experiences with hospital care in a standardized way and publicly report results. This has made it possible to compare patient experiences across hospitals. HCAHPS includes questions covering domains such as nurse and doctor communication, hospital cleanliness, pain management, discharge information, and overall satisfaction. Implemented in 2006, the survey was developed through collaboration between the Centers for Medicare & Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ), and it has become a transparency tool that creates incentives for hospitals to improve care quality.
For Medicare-participating hospitals, reporting HCAHPS results is mandatory and the results are published publicly. CMS releases HCAHPS survey results quarterly on Medicare’s Care Compare website and provides downloadable data files for researchers. This enables academics and managers to examine hospitals’ patient experience performance. In addition, detailed information about HCAHPS results and methodology is available on the official HCAHPS website. HCAHPS data are widely used in health management to improve patient satisfaction, redesign service processes, and conduct inter-hospital comparisons. Beyond HCAHPS, many hospitals also use internal patient satisfaction tools provided by companies such as Press Ganey; however, HCAHPS stands out because it is standardized nationwide.
Employee Satisfaction and Safety Culture Surveys
Hospital employees’ satisfaction and workplace safety culture directly affect care quality. U.S. hospitals use various employee satisfaction and patient safety culture surveys to understand staff perceptions. One widely used instrument is the Hospital Survey on Patient Safety Culture (HSOPSC) developed by AHRQ, which measures staff perceptions of the safety climate. The survey gathers views on issues such as openness to error reporting, management support for safety, team communication, and workload. AHRQ’s safety culture survey helps hospitals identify strengths and weaknesses and implement improvements; hundreds of hospitals conduct the survey, and AHRQ compiles results and publishes benchmarking reports. For example, the 2018 comparative report, with participation from more than 630 hospitals, showed teamwork and leadership as areas of strength, while handoffs and inadequate staffing were common areas for improvement. Academics can access these reports through AHRQ’s website and, when appropriate, request raw data from AHRQ for research purposes.
In addition, hospitals administer employee engagement and satisfaction surveys. Many organizations conduct annual surveys for nurses and other staff to track job satisfaction, burnout, and suggestions for improvement. These surveys are typically conducted internally or by third-party firms such as Press Ganey or Gallup. The resulting data guide management in developing policies to improve motivation. Because strong safety culture and high employee satisfaction positively influence care quality and organizational performance, these domains are critical from a health management perspective.
Quality Assessment (Quality Monitoring Surveys and Systems)
A range of indicators and programs exist to evaluate the quality of care delivered in hospitals. CMS and other organizations have established a comprehensive monitoring infrastructure that uses both survey data and administrative data to measure clinical quality. For example, under CMS’s Hospital Quality Initiative, core quality indicators are defined and results are publicly available. These indicators include process measures (whether guideline-concordant care is delivered), outcome measures (such as 30-day mortality or readmission rates), and patient safety performance (such as healthcare-associated infection rates and surgical complications). Patient experience is also part of quality assessment and is measured nationally through HCAHPS. These quality indicators help hospitals identify strengths and weaknesses and design quality improvement initiatives.
Accreditation bodies also play a role in hospital-level quality assessment. For instance, accreditation surveys conducted by The Joint Commission (TJC) evaluate whether hospitals comply with established quality and safety standards. Joint Commission accreditation is generally viewed as a marker that a hospital meets safety and quality standards. During accreditation, practices in many domains, such as infection control, patient rights, and emergency management, are reviewed, and the process contributes to continuous quality improvement. Results are typically binary (accredited or not accredited), and while detailed data are not usually made public, accredited hospitals are listed on TJC’s website and hospitals may share their own quality reports with their communities.
In addition, organizations such as the National Quality Forum (NQF) endorse and disseminate quality measures, and bodies such as the American Medical Association (AMA) or the National Committee for Quality Assurance (NCQA) develop quality standards in specific areas. Collectively, these efforts aim to enable health managers to assess care quality using objective criteria and identify improvement opportunities.
Performance Measurement Programs (CMS and Others)
Performance measurement involves operating accountability and incentive mechanisms based on hospitals’ outcomes on quality indicators. Through Medicare, CMS administers several performance-based payment programs for hospitals. For example, the Hospital Value-Based Purchasing program provides financial incentives based on hospitals’ clinical quality outcomes and HCAHPS patient experience scores. With the 2010 Affordable Care Act, HCAHPS patient experience scores were incorporated into value-based incentive calculations starting in 2012, meaning that a hospital’s HCAHPS performance can translate into Medicare payment bonuses or penalties. Similarly, the Hospital Readmissions Reduction Program reduces payments to hospitals with high 30-day readmission rates for selected conditions. The Hospital-Acquired Conditions program also financially penalizes hospitals with high rates of preventable infections and complications. Such performance programs are important management tools that motivate hospitals to improve quality and safety.
For transparency, performance data are also publicly available. CMS publishes up-to-date results for each hospital on Care Compare and through the Provider Data Catalog (data.cms.gov). Today, CMS publicly reports more than 150 hospital quality and performance measures. These include mortality rates, readmission rates, surgical complications, infection rates, wait times, and HCAHPS patient experience scores. Academics and managers can download these datasets in CSV or Excel format from CMS’s data catalog and conduct their own performance analyses. Organizations such as the National Bureau of Economic Research (NBER) also curate CMS datasets for researchers. These comprehensive datasets are essential for comparing hospitals, tracking trends over time, and conducting policy analyses.
In addition, the Leapfrog Group, a non-government initiative, conducts annual voluntary surveys to assess hospital safety and quality. The Leapfrog Hospital Survey evaluates hospitals based on national measures such as intensivist staffing, use of safe surgery checklists, and maternal–infant health indicators. Results for participating hospitals are publicly disclosed, and Leapfrog also assigns each hospital a patient safety grade (A, B, C, etc.) based on these data. This initiative informs consumers’ hospital choices and creates pressure on hospital leaders to adopt industry-standard practices. Leapfrog data and reports can be accessed via Leapfrog’s website, and detailed results can be examined at the hospital level.
Access to Healthcare Surveys (NHIS, MEPS, etc.)
Access to healthcare is a key domain to monitor, especially for public health and health management planning. Access surveys reveal the extent to which the population obtains needed care, the barriers encountered, and insurance coverage status. One major instrument is the National Health Interview Survey (NHIS). Conducted annually since 1957 by the National Center for Health Statistics within the Centers for Disease Control and Prevention (CDC), NHIS produces nationally representative data on topics such as health status, insurance coverage, routine care, and delayed or foregone treatment. NHIS data are provided as public-use datasets and annual reports on the CDC website, allowing researchers to access microdata and conduct regional or demographic analyses.
Another critical source is the Medical Expenditure Panel Survey (MEPS) administered by AHRQ. MEPS uses a panel design to collect detailed household-level data on healthcare use, expenditures, and barriers to access across the year. The “Access to Care” component covers whether individuals have a usual source of care (such as a primary care provider), characteristics of that provider, satisfaction with care received, and access problems related to medical services, dental care, or medications. AHRQ publishes findings in statistical briefs and also provides downloadable microdata for researchers. As a result, academics can analyze MEPS files to examine issues such as income-based inequalities in access to care or barriers associated with lack of insurance.
In addition, CDC-supported surveys such as the Behavioral Risk Factor Surveillance System (BRFSS) are conducted by telephone at the state level to track healthcare use and barriers. Foundations such as the Commonwealth Fund periodically conduct international comparative surveys on access and health system performance, enabling comparisons of the United States with other countries. Together, these access-focused efforts help health managers identify which groups face difficulties obtaining care and inform policy development.
American Hospital Association (AHA) and Other Data Sources
Comprehensive hospital data in the United States are not limited to surveys. The American Hospital Association (AHA) conducts a large-scale Annual Survey of hospitals nationwide. This survey collects extensive data on hospital capacity, service lines, staffing levels, technology use, and financial indicators. The AHA Annual Survey includes more than 1,300 data points on roughly 6,200 hospitals and 400 health systems and has collected data electronically since 1980. It is regarded as one of the most reliable and consistent sources for tracking annual hospital trends. While AHA shares summary statistics and trend reports publicly, detailed datasets are typically provided to members and researchers through paid licensing. Many academic institutions have subscription agreements for AHA data access; for example, researchers may access these data via their university’s resources such as Wharton Research Data Services or through the AHA Data portal. AHA data are widely used in health services management research to analyze hospital size, service diversification, human resources, and financial performance.
Another major source is the Healthcare Cost and Utilization Project (HCUP) databases. Coordinated by AHRQ, HCUP is a massive repository built from hospital discharge administrative records. It includes datasets such as the National Inpatient Sample (NIS) and state-level patient outcomes databases. Because HCUP is based on actual patient records rather than survey responses, it is widely used for research on hospital care quality (for example, complication rates) and cost analyses. Academics can access HCUP through AHRQ-defined protocols, typically by purchasing data or conducting analyses through approved data environments.
Finally, there are many other research and data collection initiatives conducted by federal and state agencies. For example, AHRQ’s National Healthcare Quality and Disparities Report summarizes national health system performance annually using data from multiple sources. Medicare’s open data initiatives share many datasets, including hospital spending and physician reporting. All these sources support evidence-based decision-making in health management by providing inputs for academic research and helping policymakers and hospital leaders identify improvement priorities.
References: Compiled from various official agency websites and publications, such as CMS’s HCAHPS information pages, CMS Care Compare and Provider Data Catalog documentation, AHRQ’s survey instruments and MEPS documentation, AHA’s Annual Survey information pages, and related reports.