Measuring patients’ experiences with individual primary care physicians

Safran, Dana Gelb; Karp, Melinda; Coltin, Kathryn L.; Chang, Hong; Li, Angela; Ogren, J. A.; Rogers, William H.

doi:10.1111/j.1525-1497.2005.00311.x

Cited by 198 publications

(204 citation statements)

References 35 publications

(33 reference statements)

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“…Prior analyses of this survey process have confirmed that survey nonresponse does not pose a threat to the validity of the findings, with no differences across physician practices in individuals' propensity to respond to the survey according to age, race, education, and socioeconomic status. 12 We limited our analyses to practice sites with data available on both patient experiences and HEDIS measures (n=334).…”

Section: Practice Site Datamentioning

confidence: 99%

“…16 Patient experience data were derived from MHQP's administration of the ACES instrument, which produces summary measures covering quality of clinical interactions and organizational features of care (Table 2). 12 The survey sample consisted of adults 18 to 64 years of age with at least 1 year of continuous enrollment in one of five participating health plans, and at least one visit with the primary care physician in the last 12 months. The survey was fielded between July and September 2005 using a three-stage mail protocol, 17 beginning with a mailing containing a cover letter on their health plan stationery and a copy of the survey, followed by a reminder post card (2 weeks later) and a second survey packet to nonrespondents (1 week later).…”

Section: Practice Site Datamentioning

confidence: 99%

“…12 Numeric composite scores for both patient experience and clinical quality measures were calculated using the adjusted half-scale rule to produce ratings on a scale from 0 to 100, with higher scores representing either better patient experiences or superior clinical quality. This method has been described previously, 25 and involves first transforming the individual item to a 0 to 100 scale based on the number of responses.…”

Section: Composite Measure Creationmentioning

confidence: 99%

“…5 The Ambulatory Care Experiences Survey (ACES) is one such measurement tool developed specifically for use in the assessment of patient experiences of primary care, 11 providing an assessment of both organizational features of care and the quality of clinical interactions. 12 As physician groups and individual physicians strive to deliver care that is both clinically effective and patientcentered, 13,14 it is increasingly important to improve our understanding of the relationship between measures of clinical performance and patient experience. Physicians may express concern that conflicts arise as systems are implemented to standardize care across all patients to assure outstanding clinical performance, while the delivery of patient-centered care may ultimately rely on customizing care to suit the needs of a particular patient.…”

Section: Introductionmentioning

confidence: 99%

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Quality Monitoring of Physicians: Linking Patients’ Experiences of Care to Clinical Quality and Outcomes

et al. 2008

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BACKGROUND: Physicians are increasingly asked to improve the delivery of clinical services and patient experiences of care. OBJECTIVE:We evaluated the association between clinical performance and patient experiences in a statewide sample of physician practice sites and a sample of physicians within a large physician group. DESIGN, SETTING, PARTICIPANTS:We separately identified 373 practice sites and 119 individual primary care physicians in Massachusetts. MEASUREMENTS: Using Health Plan Employer Dataand Information Set data, we produced two composites addressing processes of care (prevention, disease management) and one composite addressing outcomes. Using Ambulatory Care Experiences Survey data, we produced seven composite measures summarizing the quality of clinical interactions and organizational features of care. For each sample (practice site and individual physician), we calculated adjusted Spearman correlation coefficients to assess the relationship between the composites summarizing patient experiences of care and those summarizing clinical performance.RESULTS: Among 42 possible correlations (21 correlations involving practice sites and 21 involving individual physicians), the majority were positive in site level (71%) and physician level (67%) analyses. For the 28 possible correlations involving patient experiences and clinical process composites, 8 (29%) were significant and positive, and only 2 (7%) were significant and negative. The magnitude of the significant positive correlations ranged from 0.13 to 0.19 at the site level and from 0.28 to 0.51 at the physician level. There were no significant correlations between patient experiences and the clinical outcome composite. CONCLUSIONS:The modest correlations suggest that clinical quality and patient experience are distinct, but related domains that may require separate measurement and improvement initiatives.KEY WORDS: quality of care; patient centered care; primary care; quality measurement; quality improvement.

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Section: Practice Site Datamentioning

confidence: 99%

Section: Practice Site Datamentioning

confidence: 99%

Section: Composite Measure Creationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Quality Monitoring of Physicians: Linking Patients’ Experiences of Care to Clinical Quality and Outcomes

et al. 2008

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“…The study questionnaire used is the Ambulatory Care Experiences Survey (ACES), a validated survey that measures patients' experiences with a specific, named PCP and that physician's practice 18 . Patients were asked two questions related to visit continuity.…”

Section: Patient-reported Measuresmentioning

confidence: 99%

Primary Care Physician Visit Continuity: A Comparison of Patient-reported and Administratively Derived Measures

et al. 2008

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BACKGROUND: Studies find that primary care physician (PCP) visit continuity is positively associated with care quality. Some of the evidence base, however, relies on patient-reported continuity measures, which may be subject to response bias. OBJECTIVE:To assess the concordance of patientreported and administratively derived visit continuity measures. DESIGN:Random samples of patients (n =15,126) visiting 1 of 145 PCPs from a physician organization in Massachusetts were surveyed. Respondents reported their experienced visit continuity over the preceding 6 months. Usual Provider Continuity (UPC), an administratively derived measure, was calculated for each respondent. The concordance of patient reports and UPC was examined. Associations with patient-reported physician-patient interaction quality were assessed for both measures. RESULTS:Patient-reported and administratively derived visit continuity measures were moderately correlated for overall (r=0.30) and urgent (r=0.30) measures and modestly correlated for the routine (r=0.17) measure. Although patient reports and UPC were significantly associated with the physician-patient interaction quality (p<0.001), the effect size for patient-reports was approximately five times larger than the effect size for UPC.CONCLUSIONS: Studies and quality initiatives seeking to evaluate visit continuity should rely on administratively derived measures whenever possible. Patientreported measures appear to be subject to biases that can overestimate the relationship between visit continuity and some patient-reported outcomes.KEY WORDS: continuity of care; quality measurement; patient-reported outcomes; physician-patient communication.

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A Framework for Increasing Trust Between Patients and the Organizations That Care for Them

Lee

McGlynn

Safran

2019

JAMA

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Trust matters in health care. It makes patients feel less vulnerable, clinicians feel more effective, and reduces the imbalances of information by improving the flow of information. Trust is so fundamental to the patientphysician relationship that it is easy to assume it exists. But because of changes in health care and society at large, trust is increasingly understood to be at risk and in need of attention. 1

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Measuring patients’ experiences with individual primary care physicians

Cited by 198 publications

References 35 publications

Quality Monitoring of Physicians: Linking Patients’ Experiences of Care to Clinical Quality and Outcomes

Quality Monitoring of Physicians: Linking Patients’ Experiences of Care to Clinical Quality and Outcomes

Primary Care Physician Visit Continuity: A Comparison of Patient-reported and Administratively Derived Measures

A Framework for Increasing Trust Between Patients and the Organizations That Care for Them

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