The inpatient experience of emerging adults in the United States

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.