CAHPS and Comments: How Closed-Ended Survey Questions and Narrative Accounts Interact in the Assessment of Patient Experience

doi:10.1177/2374373516685940

. 2017 Mar;4(1):37-45.

doi: 10.1177/2374373516685940. Epub 2017 Jan 1.

CAHPS and Comments: How Closed-Ended Survey Questions and Narrative Accounts Interact in the Assessment of Patient Experience

Steven C Martino¹, Dale Shaller², Mark Schlesinger³, Andrew M Parker¹, Lise Rybowski⁴, Rachel Grob^{5

6}, Jennifer L Cerully¹, Melissa L Finucane¹

Affiliations

¹ RAND Corporation, Pittsburgh, PA, USA.
² Shaller Consulting Group, Stillwater, MN, USA.
³ Department of Health Policy and Management, Yale University School of Public Health, New Haven, CT, USA.
⁴ The Severyn Group, Inc, Ashburn, VA, USA.
⁵ Center for Patient Partnerships, University of Wisconsin Law School, Madison, WI, USA.
⁶ Department of Family Medicine, University of Wisconsin Medical School, Madison, WI, USA.

PMID: 28725858
PMCID: PMC5513663
DOI: 10.1177/2374373516685940

CAHPS and Comments: How Closed-Ended Survey Questions and Narrative Accounts Interact in the Assessment of Patient Experience

Steven C Martino et al. J Patient Exp. 2017 Mar.

. 2017 Mar;4(1):37-45.

doi: 10.1177/2374373516685940. Epub 2017 Jan 1.

Authors

Steven C Martino¹, Dale Shaller², Mark Schlesinger³, Andrew M Parker¹, Lise Rybowski⁴, Rachel Grob^{5

6}, Jennifer L Cerully¹, Melissa L Finucane¹

Affiliations

¹ RAND Corporation, Pittsburgh, PA, USA.
² Shaller Consulting Group, Stillwater, MN, USA.
³ Department of Health Policy and Management, Yale University School of Public Health, New Haven, CT, USA.
⁴ The Severyn Group, Inc, Ashburn, VA, USA.
⁵ Center for Patient Partnerships, University of Wisconsin Law School, Madison, WI, USA.
⁶ Department of Family Medicine, University of Wisconsin Medical School, Madison, WI, USA.

PMID: 28725858
PMCID: PMC5513663
DOI: 10.1177/2374373516685940

Abstract

Objectives: To investigate whether content from patient narratives explains variation in patients' primary care provider (PCP) ratings beyond information from the closed-ended questions of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician and Group Survey and whether the relative placement of closed- and open-ended survey questions affects either the content of narratives or the CAHPS composite scores.

Methods: Members of a standing Internet panel (N = 332) were randomly assigned to complete a CAHPS survey that was either preceded or followed by a set of open-ended questions about how well their PCP meets their expectations and how they relate to their PCP.

Results: Narrative content from healthier patients explained only an additional 2% beyond the variation in provider ratings explained by CAHPS composite measures. Among sicker patients, narrative content explained an additional 10% of the variation. The relative placement of closed- and open-ended questions had little impact on narratives or CAHPS scores.

Conclusion: Incorporating a protocol for eliciting narratives into a patient experience survey results in minimal distortion of patient feedback. Narratives from sicker patients help explain variation in provider ratings.

Keywords: CAHPS; patient comments; patient experience; patient narratives.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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References

1. Anhang Price R, Elliott MN, Zaslavsky AM, Hays RD, Lehrman WG, Rybowski L, et al. Examining the role of patient experience surveys in measuring health care quality. Med Care Res Rev. 2014;71:522–54. - PMC - PubMed
1. Anhang Price R, Elliot MN, Cleary PD, Zaslavsky AM, Hays RD. Should health care providers be accountable for patients’ care experiences? J Gen Intern Med. 2015;30:253–6. - PMC - PubMed
1. Greaves F, Ramirez-Cano D, Millett C, Darzi A, Donaldson L. Harnessing the cloud of patient experience: using social media to detect poor quality healthcare. BMJ Qual Saf. 2013;22:251–5. - PubMed
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[1] Anhang Price R, Elliott MN, Zaslavsky AM, Hays RD, Lehrman WG, Rybowski L, et al. Examining the role of patient experience surveys in measuring health care quality. Med Care Res Rev. 2014;71:522–54. - PMC - PubMed

[2] Anhang Price R, Elliott MN, Zaslavsky AM, Hays RD, Lehrman WG, Rybowski L, et al. Examining the role of patient experience surveys in measuring health care quality. Med Care Res Rev. 2014;71:522–54. - PMC - PubMed

[3] Anhang Price R, Elliot MN, Cleary PD, Zaslavsky AM, Hays RD. Should health care providers be accountable for patients’ care experiences? J Gen Intern Med. 2015;30:253–6. - PMC - PubMed

[4] Anhang Price R, Elliot MN, Cleary PD, Zaslavsky AM, Hays RD. Should health care providers be accountable for patients’ care experiences? J Gen Intern Med. 2015;30:253–6. - PMC - PubMed

[5] Greaves F, Ramirez-Cano D, Millett C, Darzi A, Donaldson L. Harnessing the cloud of patient experience: using social media to detect poor quality healthcare. BMJ Qual Saf. 2013;22:251–5. - PubMed

[6] Greaves F, Ramirez-Cano D, Millett C, Darzi A, Donaldson L. Harnessing the cloud of patient experience: using social media to detect poor quality healthcare. BMJ Qual Saf. 2013;22:251–5. - PubMed

[7] Lagu T, Greaves F. From public to social reporting of hospital quality. J Gen Intern Med. 2015;30:1397–9. - PMC - PubMed

[8] Lagu T, Greaves F. From public to social reporting of hospital quality. J Gen Intern Med. 2015;30:1397–9. - PMC - PubMed

[9] Lagu T, Lindenaur PK. Putting the public back in public reporting of health care quality. JAMA. 2010;304:171–2. - PubMed

[10] Lagu T, Lindenaur PK. Putting the public back in public reporting of health care quality. JAMA. 2010;304:171–2. - PubMed

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CAHPS and Comments: How Closed-Ended Survey Questions and Narrative Accounts Interact in the Assessment of Patient Experience

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CAHPS and Comments: How Closed-Ended Survey Questions and Narrative Accounts Interact in the Assessment of Patient Experience

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Abstract

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