Effects of Survey Mode, Patient Mix, and Nonresponse on CAHPS Hospital Survey Scores

Health Serv Res. 2009 Apr;44(2 Pt 1):501-18. doi: 10.1111/j.1475-6773.2008.00914.x.

Abstract

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.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Diagnosis-Related Groups
  • Female
  • Health Care Surveys / methods*
  • Health Care Surveys / statistics & numerical data*
  • Hospitals / statistics & numerical data
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Models, Organizational
  • Patient Discharge*
  • Patient Satisfaction
  • Young Adult