Debating Survey Approaches

Cleary, Paul D.; Lubalin, James S.; Short, Pamela Farley; Edgman‐Levitan, Susan; Sheridan, Samantha

doi:10.1377/hlthaff.17.1.265

Cited by 19 publications

(17 citation statements)

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“…To ensure that patient experience data is actionable for health care providers and meaningful to consumers and patients, surveys should inquire about specific care experiences, such as whether nurses and doctors listened carefully, rather than overall satisfaction, which is highly subjective (Cleary 1998; Cleary et al, 1998). …”

Section: Discussionmentioning

confidence: 99%

Examining the Role of Patient Experience Surveys in Measuring Health Care Quality

et al. 2014

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Patient care experience surveys evaluate the degree to which care is patient-centered. This article reviews the literature on the association between patient experiences and other measures of health care quality. Research indicates that better patient care experiences are associated with higher levels of adherence to recommended prevention and treatment processes, better clinical outcomes, better patient safety within hospitals, and less health care utilization. Patient experience measures that are collected using psychometrically sound instruments, employing recommended sample sizes and adjustment procedures, and implemented according to standard protocols are intrinsically meaningful and are appropriate complements for clinical process and outcome measures in public reporting and pay-for-performance programs.

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Section: Discussionmentioning

confidence: 99%

Examining the Role of Patient Experience Surveys in Measuring Health Care Quality

et al. 2014

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“…Global ratings are overall subjective assessments, whereas report items are more specific and thought to be more objective (Cleary et al 1998). We disaggregate composites into report items in order to examine proxy effects at the item level.…”

Section: Methodsmentioning

confidence: 99%

How Do Proxy Responses and Proxy‐Assisted Responses Differ from What Medicare Beneficiaries Might Have Reported about Their Health Care?

Elliott

Beckett

Chong³

et al. 2008

Health Services Research

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Objective. Assess proxy respondent effects on health care evaluations by Medicare beneficiaries. Data Source. 110,215 respondents from the nationally representative 2001 CAHPS® Medicare Fee‐for‐Service Survey. Study Design/Data Collection/Extraction Methods. We compare the effects of both proxy respondents and proxy assistance (reading, writing, or translating) on 23 “objective” report items and four “subjective” global measures of health care experiences using propensity‐score‐weighted regression. We assess whether proxy effects differ among spouses, other relatives, or nonrelatives. Principal Findings. Proxy respondents provide less positive evaluations of beneficiary health care experiences than otherwise similar self‐reporting beneficiaries for more subjective global ratings (average effect of 0.21 standard deviations); differences are smaller for relatively objective and specific report items. Proxy assistance differences are similar, but about half as large. Reports from spouse proxy respondents are more positive than those from other proxies and are similar to what would have been reported by the beneficiaries themselves. Standard regression techniques may overestimate proxy effects in this instance. Conclusions. One should treat proxy responses to subjective ratings cautiously. Even seemingly innocuous reading, writing, and translation by proxies may influence answers. Spouses may be accurate proxies for the elderly in evaluations of health care.

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“…In addition, surveys should inquire about specific care experiences, such as whether the health care provider listened carefully, rather than overall satisfaction, which is highly subjective. 3 Most CAHPS survey questions ask about specific experiences of care. The surveys are tailored to different care settings, so that results can be used to help identify aspects of care that can be targeted to improve patient experiences.…”

Section: Patient Surveys Do Not Provide Valid Information Aboutmentioning

confidence: 99%

Should Health Care Providers be Accountable for Patients’ Care Experiences?

Price

Elliott

Cleary³

et al. 2014

J GEN INTERN MED

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Measures of patients' care experiences are increasingly used as quality measures in accountability initiatives. As the prominence and financial impact of patient experience measures have increased, so too have concerns about the relevance and fairness of including them as indicators of health care quality. Using evidence from the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) surveys, the most widely used patient experience measures in the United States, we address seven common critiques of patient experience measures: (1) consumers do not have the expertise needed to evaluate care quality; (2) patient "satisfaction" is subjective and thus not valid or actionable; (3) increasing emphasis on improving patient experiences encourages health care providers and plans to fulfill patient desires, leading to care that is inappropriate, ineffective, and/or inefficient; (4) there is a trade-off between providing good patient experiences and providing high-quality clinical care; (5) patient scores cannot be fairly compared across health care providers or plans due to factors beyond providers' control; (6) response rates to patient experience surveys are low, or responses reflect only patients with extreme experiences; and (7) there are faster, cheaper, and more customized ways to survey patients than the standardized approaches mandated by federal accountability initiatives.

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Debating Survey Approaches

Cited by 19 publications

References 0 publications

Examining the Role of Patient Experience Surveys in Measuring Health Care Quality

Examining the Role of Patient Experience Surveys in Measuring Health Care Quality

How Do Proxy Responses and Proxy‐Assisted Responses Differ from What Medicare Beneficiaries Might Have Reported about Their Health Care?

Should Health Care Providers be Accountable for Patients’ Care Experiences?

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