Less Use of Extreme Response Options by Asians to Standardized Care Scenarios May Explain Some Racial/Ethnic Differences in CAHPS Scores

Mayer, Lauren A.; Elliott, Marc N.; Haas, Ann C.; Weinick, Robin M.

doi:10.1097/mlr.0000000000000453

Cited by 27 publications

(34 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There were some differences between Whites and Asians on a subset of factor loadings, item intercepts, and error terms (Table 3). Of note, 2 of the item intercepts (explanations and global ratings of care overall) were more positive for Whites than Asians, consistent with a nationally representative study that Asians (n = 575) gave more negative evaluations than Whites (n = 505) of a vignette representing better patient care [15].…”

Section: Discussionsupporting

confidence: 62%

“…The degree of measurement equivalence observed in this and the prior study is important given evidence that Asians are less likely than Whites to use the extremes of response scales [14,15]. There were some differences between Whites and Asians on a subset of factor loadings, item intercepts, and error terms (Table 3).…”

Section: Discussionmentioning

confidence: 92%

“…But an evaluation of the CAHPS hospital survey reported a difference in an item intercept on communication about medicines between Whites and Asians [13]. In addition, there is evidence that Asians are less likely than Whites to select options at the extreme ends of the response scale [14,15].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Measurement equivalence of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Medicare survey items between non-Hispanic whites and Asians.

Chawla

Kent

Arora

2016

JCO

Self Cite

View full text Add to dashboard Cite

Purpose Asians report worse experiences with care than Whites. This could be due to true differences in care received, expectations about care, or survey response styles. We examined responses to the Consumer Assessment of Healthcare Providers and Systems (CAHPS Ò ) Medicare survey items by Whites and Asians, controlling for underlying level on the CAHPS constructs. Methods We conducted multiple group analyses to evaluate measurement equivalence of CAHPS Medicare survey data between White and Asian Medicare beneficiaries for CAHPS reporting composites (communication with personal doctor, access to care, plan customer service) and global ratings of care using pooled data from 2007 to 2011. Responses were obtained from 1,326,410 non-Hispanic Whites and 40,672 non-Hispanic Asians (hereafter referred to as Whites and Asians). The median age for Whites was 70, with 24 % 80 or older, and 70 for Asians, with 23 % 80 or older. Fifty-eight percent of Whites and 56 % of Asians were female. Results A model without group-specific estimates fit the data as well as a model that included 12 group-specific estimates (7 factor loadings, 3 measured variable errors, and 2 item intercepts): Comparative Fit Index = 0.947 and 0.948; root-mean-square error of approximation = 0.052 and 0.052, respectively). Differences in latent CAHPS score means between Whites and Hispanics estimated from the two models were similar, differing by 0.053 SD or less. Conclusions This study provides support for measurement equivalence of the CAHPS Medicare survey composites (communication, access, customer service) and global ratings between White and Asian respondents, supporting comparisons of care experiences between the two groups.

show abstract

Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 92%

See 1 more Smart Citation

Measurement equivalence of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Medicare survey items between non-Hispanic whites and Asians.

Chawla

Kent

Arora

2016

JCO

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 78%

Measurement equivalence of the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Medicare survey items between Whites and Asians

2016

Self Cite

View full text Add to dashboard Cite

Purpose Asians report worse experiences with care than Whites. This could be due to true differences in care received, expectations about care, or survey response styles. We examine responses to the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Medicare survey items by Whites and Asians, controlling for underlying level on the CAHPS constructs. Methods We conducted multiple group analyses to evaluate measurement equivalence of CAHPS Medicare survey data between White and Asian Medicare beneficiaries for CAHPS reporting composites (communication with personal doctor, access to care, plan customer service) and global ratings of care using pooled data from 2007–2011. Responses were obtained from 1,326,410 non-Hispanic Whites and 40,672 non-Hispanic Asians (hereafter referred to as Whites and Asians). The median age for Whites was 70, with 24% 80 or older, and 70 for Asians, with 23% 80 or older. Fifty-eight percent of Whites and 56% of Asians were female. Results A model without group-specific estimates fit the data as well as a model that included 12 group-specific estimates (7 factor loadings, 3 measured variable errors, and 2 item intercepts): Comparative Fit Index = 0.947 and 0.948; Root Mean Square Error of Approximation = 0.052 and 0.052, respectively). Differences in latent CAHPS score means between Whites and Hispanics estimated from the two models were similar, differing by 0.053 SD or less. Conclusions This study provides support for measurement equivalence in response to the CAHPS Medicare survey composites (communication, access, customer service) and global ratings between White and Asian respondents, supporting comparisons of care experiences between the two groups.

show abstract

“…37 However, recent evidence shows that blacks, whites, and Hispanics similarly interpret objective measures of patient experiences, such as those used in this study. 38 As with all surveys, nonresponse bias may have influenced our findings.…”

Section: Discussionmentioning

confidence: 84%

Racial/Ethnic Disparities in Medicare Beneficiaries’ Care Coordination Experiences

et al. 2016

Self Cite

View full text Add to dashboard Cite

Background: Little is known about racial/ethnic differences in the experience of care coordination. To the extent that they exist, such differences may exacerbate health disparities given the higher prevalence of some chronic conditions among minorities. Objective: To investigate the extent to which racial/ethnic disparities exist in the receipt of coordinated care by Medicare beneficiaries. Subjects: A total of 260,974 beneficiaries who responded to the 2013 Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. Methods: We fit a series of linear, case-mix adjusted models predicting Medicare CAHPS measures of care coordination from race/ethnicity. Results: Hispanic, black, and Asian/Pacific Islander (API) beneficiaries reported that their personal doctor had medical records and other relevant information about their care significantly less often than did non-Hispanic white beneficiaries (−2 points for Hispanics, −1 point for blacks, and −4 points for APIs on a 100-point scale). These 3 groups also reported significantly greater difficulty getting timely follow-up on test results than non-Hispanic white beneficiaries (−9 points for Hispanics, −1 point for blacks, −5 points for APIs). Hispanic and black beneficiaries reported that help was provided in managing their care significantly less often than did non-Hispanic white beneficiaries (−2 points for Hispanics, −3 points for blacks). API beneficiaries reported that their personal doctor discussed their medications and had up-to-date information on care from specialists significantly less often than did non-Hispanic white beneficiaries (−2 and −4 points, respectively). Discussion: These results suggest a need for efforts to address racial/ethnic disparities in care coordination to help ensure high-quality care for all patients. Public reporting of plan-level performance data by race/ethnicity may also be helpful to Medicare beneficiaries and their advocates.

show abstract

Less Use of Extreme Response Options by Asians to Standardized Care Scenarios May Explain Some Racial/Ethnic Differences in CAHPS Scores

Cited by 27 publications

References 35 publications

Measurement equivalence of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Medicare survey items between non-Hispanic whites and Asians.

Measurement equivalence of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Medicare survey items between non-Hispanic whites and Asians.

Measurement equivalence of the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Medicare survey items between Whites and Asians

Racial/Ethnic Disparities in Medicare Beneficiaries’ Care Coordination Experiences

Contact Info

Product

Resources

About