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Effects of Survey Mode, Patient Mix, and Nonresponse on CAHPS ® Hospital Survey Scores
Author(s) -
Elliott Marc N.,
Zaslavsky Alan M.,
Goldstein Elizabeth,
Lehrman William,
Hambarsoomians Katrin,
Beckett Megan K.,
Giordano Laura
Publication year - 2009
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/j.1475-6773.2008.00914.x
Subject(s) - case mix index , medicine , patient satisfaction , randomized controlled trial , telephone survey , percentile , non response bias , health care , family medicine , emergency medicine , statistics , nursing , surgery , mathematics , pathology , marketing , economics , business , economic growth
Objective. To evaluate the need for survey mode adjustments to hospital care evaluations by discharged inpatients and develop the appropriate adjustments. Data Source. A total of 7,555 respondents from a 2006 national random sample of 45 hospitals who completed the CAHPS ® Hospital (HCAHPS [Hospital Consumer Assessments of Healthcare Providers and Systems]) Survey. Study Design/Data Collection/Extraction Methods. We estimated mode effects in linear models that predicted each HCAHPS outcome from hospital‐fixed effects and patient‐mix adjustors. Principal Findings. Patients randomized to the telephone and active interactive voice response (IVR) modes provided more positive evaluations than patients randomized to mail and mixed (mail with telephone follow‐up) modes, with some effects equivalent to more than 30 percentile points in hospital rankings. Mode effects are consistent across hospitals and are generally larger than total patient‐mix effects. Patient‐mix adjustment accounts for any nonresponse bias that could have been addressed through weighting. Conclusions. Valid comparisons of hospital performance require that reported hospital scores be adjusted for survey mode and patient mix.