Katrin Hambarsoomian
Biographic Data
| ID | 234361 |
|---|---|
| NAME | Katrin Hambarsoomian |
| GIVEN NAMES | Katrin |
| FAMILY NAME | Hambarsoomian |
| SIGNATURE | HAMBARSOOMIAN K |
| AFFILIATIONS | RAND Corporation, Santa Monica, CA |
| VERIFIED | No |
| TOTAL WORKS | 24 |
| TOTAL CITATIONS | 56 |
| AUTHOR COUNT | 24 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2005 |
| LATEST PUBLICATION YEAR | 2025 |
| H-INDEX | 3 |
Comparison of Alternative Approaches to Using Race-and-Ethnicity Data in Estimating Differences in Health Care and Social Determinants of Health
OBJECTIVE: The objective of this study was to compare 2 approaches for representing self-reported race-and-ethnicity, additive modeling (AM), in which every race or ethnicity a person endorses counts toward measurement of that category, and a commonly used mutually exclusive categorization (MEC) approach. The benchmark was a gold-standard, but often impractical approach that analyzes all combinations of race-and-ethnicity as distinct groups. METH…
Supplemental Items Reduce HCAHPS Response Rates, but Response Rates Do Not Affect HCAHPS Scores: A Randomized Experiment
BACKGROUND: Longer surveys can reduce response rates (RRs). Observational data suggest a positive hospital-level association between RRs and HCAHPS scores, but a negative patient-level relationship. There is no experimental evidence of whether a hospital's RR affects its HCAHPS scores. OBJECTIVES: Estimate the effect of the 59-item versus 32-item survey on RR by survey mode; assess whether any reductions in RR change HCAHPS scores. RESEARCH DESIG…
Evaluation of Proposed New Measures for the Hospital CAHPS Survey
Background: Since its 2006 launch, the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey has become the most used hospital patient experience survey, included in public reporting and accountability systems. Responding to emerging evidence of possible gaps in survey content, the Centers for Medicare & Medicaid Services undertook extensive efforts to develop and test new HCAHPS measures. Objectives: Describe the devel…
Updated Adjustment of the HCAHPS Survey for New Modes of Survey Administration and Patient Mix
BACKGROUND: Web-first multimode survey protocols increase Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey response rates and representativeness but may result in different HCAHPS scores because of survey mode effects and selective email address availability. A variable absent from many patient-mix adjustment models that may result in more positive patient experiences is whether the hospital admission was planned; …
Survey Protocols, Response Rates, and Representation of Underserved Patients: A Randomized Clinical Trial
In this randomized clinical trial, web-first multimode survey protocols significantly improved the RR and representativeness of patient surveys. The best-performing protocol based on RR and representativeness was web-mail-phone. Web-phone performed well for young and diverse patient populations, and web-mail for older and less diverse patient populations. The US Centers for Medicare & Medicaid Services will allow hospitals to use the web-mail, we…
Mixed Mode Substantially Increases Hospital Consumer Assessment of Healthcare Providers and Systems Response Rates Relative to Single-Mode Protocols
BACKGROUND: Low response rates (RRs) can affect hospitals' data collection costs for patient experience surveys and value-based purchasing eligibility. Most hospitals use single-mode approaches, even though sequential mixed mode (MM) yields higher RRs and perhaps better patient representativeness. Some hospitals may be reluctant to incur MM's potential additional cost and complexity without knowing how much RRs would increase. OBJECTIVE: The aim …
Do Hospital Characteristics Predict Racial-and-Ethnic Disparities in Patient Experience? National Results From the HCAHPS Survey
OBJECTIVE: Assess whether hospital characteristics associated with better patient experiences overall are also associated with smaller racial-and-ethnic disparities in inpatient experience. BACKGROUND: Hospitals that are smaller, non-profit, and serve high proportions of White patients tend to be high-performing overall, but it is not known whether these hospitals also have smaller racial-and-ethnic disparities in care. RESEARCH DESIGN: We used l…
Measuring Equity in the Hospital Setting: An HCAHPS Application of the Health Equity Summary Score
BACKGROUND: Health care quality varies by patient factors, including race-and-ethnicity and preferred language. Addressing inequities requires identifying them and incentivizing equity. OBJECTIVES: We apply an approach first implemented in the Medicare Advantage setting to measure equity in patient experiences by race-and-ethnicity [Asian American and Native Hawaiian or Pacific Islander (AA and NHPI), Black, Hispanic, vs. White] and language pref…
Patient Experience for Hispanic Older Adults Varies by Language Preference
BACKGROUND: Hispanic people with Medicare report worse patient experiences than non-Hispanic White counterparts. However, little research examines how these disparities may vary by language preference (English/Spanish). OBJECTIVES: Using Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey data, assess whether 2014-2018 disparities in patient experiences for Hispanic people with Medicare vary by language preference. RES…
Disparities in Care Experienced by Older Hispanic Medicare Beneficiaries in Urban and Rural Areas
BACKGROUND: Hispanic older adults face substantial health disparities compared with non-Hispanic-White (hereafter "White") older adults. To the extent that these disparities stem from cultural and language barriers faced by Hispanic people, they may be compounded by residence in rural areas. OBJECTIVE: The objective of this study was to investigate possible interactions between Hispanic ethnicity and rural residence in predicting the health care …
Measuring Inconsistency in Quality Across Patient Groups to Target Quality Improvement
BACKGROUND: Quality improvement (QI) may be aimed at improving care for all patients, or it may be targeted at only certain patient groups. Health care providers have little guidance when determining when targeted QI may be preferred. OBJECTIVES: The aim was to develop a method for quantifying performance inconsistency and guidelines for when inconsistency indicates targeted QI, which we apply to the performance of health plans for different pati…
Disparities in Care Experienced by American Indian and Alaska Native Medicare Beneficiaries
BACKGROUND: Little is known about the health care experiences of American Indians and Alaska Natives (AIANs) due to limited data. OBJECTIVE: The objective of this study was to investigate the health care experiences of AIAN Medicare beneficiaries relative to non-Hispanic Whites using national survey data pooled over 5 years. SUBJECTS: A total of 1,193,248 beneficiaries who responded to the nationally representative 2012-2016 Medicare Consumer Ass…
Indirect Estimation of Race/Ethnicity for Survey Respondents Who Do Not Report Race/Ethnicity
It may be worthwhile to impute race/ethnicity when this information is unavailable in survey data sets due to item nonresponse, especially when missingness is high
Racial/Ethnic Disparities in Medicare Beneficiaries’ Care Coordination Experiences
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 responde…
Diabetes and Cardiovascular Disease Risk in Cambodian Refugees
Using Indirect Estimates Based on Name and Census Tract to Improve the Efficiency of Sampling Matched Ethnic Couples from Marriage License Data
For many sampling applications where study goals require oversampling by race/ethnicity, self-reported race/ethnicity is unavailable. We describe a new method that allows oversampling on the basis of indirectly estimated race/ethnicity when name and address information are available. We adapt a Bayesian method for imputing self-reported race/ethnicity from surname and residential address information for use with marriage license application data …
Are There Differences in the Medicare Experiences of Beneficiaries in Puerto Rico Compared with Those in the U.S. Mainland
BACKGROUND: Little is known about the healthcare experiences of Medicare beneficiaries in Puerto Rico. OBJECTIVES: We compare the experiences of elderly Medicare beneficiaries in Puerto Rico with their English-preferring and Spanish-preferring Medicare counterparts in the U.S. mainland. RESEARCH DESIGN: Linear regression models compared mean Consumer Assessment of Healthcare Providers and Systems scores for these groups, using cross-sectional dat…
Racial/Ethnic Disparities in Medicare Part D Experiences
OBJECTIVE: To examine racial/ethnic differences in Medicare beneficiary experiences with Medicare Part D prescription drug (PD) coverage. DATA SOURCES/STUDY SETTING: 2008 Consumer Assessment of Health Care Providers and Systems survey of U.S. Medicare beneficiaries. STUDY DESIGN: Surveys were administered by mail with phone follow-up to a nationally representative sample (61% response rate). This study examines 201,496 beneficiaries of age 65 and…
Use of Expert Ratings as Sampling Strata for a More Cost-Effective Probability Sample of a Rare Population
We consider situations in which externally observable characteristics allow experts to quickly categorize individual households as likely or unlikely to contain a member of a rare target population. This classification can form the basis of disproportionate stratified sampling such that households classified as "unlikely" are sampled at a lower rate than those classified as "likely," thereby reducing screening costs. Design weights account for th…
The Relationship Between Spanish Language Use and Substance Use Behaviors Among Latino Youth: A Social Network Approach
Adolescent Participation in Preventive Health Behaviors, Physical Activity, and Nutrition: Differences Across Immigrant Generations for Asians and Latinos Compared With Whites
Objectives. We investigated preventive health behaviors (bicycle helmet, seat belt, and sunscreen use), physical activity, television viewing or video game playing, and nutrition (fruit, vegetable, milk, and soda consumption) among Asian and Latino adolescents living in the United States; assessed trends across generations (first-, second-, and third-generation immigrants or later); and compared each generation with White adolescents. Methods. We…
Predictors of Unprotected Sex with Non-cohabitating Primary Partners among Sheltered and Low-income Housed Women in Los Angeles County
This study investigated associations of substance use, relationship abuse and HIV self-protective behavior with unprotected sex among 290 impoverished women with a non-cohabitating primary partner. Unprotected sex was associated with having a physically or psychologically abusive partner among low-income housed women, and having an abusive partner who also drank to intoxication among women living in shelters. Indicators of HIV self-protective beh…
Sampling with Field Burden Constraints: An Application to Sheltered Homeless and Low-Income Housed Women
In this article, the authors present a statistically efficient, cost-effective way of collecting a probability sample in the presence of certain field burden constraints: restrictions on the maximum number of participants that can be sampled within a given institution and a small population size relative to the sample size dictated by the study aims. The authors suggest the use of disproportionate stratified random sampling as an alternative to t…
Do Medicaid and Commercial CAHPS Scores Correlate Within Plans: A New Jersey Case Study
Background: The Consumer Assessment of Health Plans Study (CAHPS) health plan survey is currently administered to large independent samples of Medicaid beneficiaries and commercial enrollees for managed care organizations that serve both populations. There is interest in reducing survey administration costs and sample size requirements by sampling these 2 groups together for health plan comparisons. Plan managers may also be interested in underst…
The Relationship Between Spanish Language Use and Substance Use Behaviors Among Latino Youth: A Social Network Approach
Adolescent Participation in Preventive Health Behaviors, Physical Activity, and Nutrition: Differences Across Immigrant Generations for Asians and Latinos Compared With Whites
Objectives. We investigated preventive health behaviors (bicycle helmet, seat belt, and sunscreen use), physical activity, television viewing or video game playing, and nutrition (fruit, vegetable, milk, and soda consumption) among Asian and Latino adolescents living in the United States; assessed trends across generations (first-, second-, and third-generation immigrants or later); and compared each generation with White adolescents. Methods. We…
Using Indirect Estimates Based on Name and Census Tract to Improve the Efficiency of Sampling Matched Ethnic Couples from Marriage License Data
For many sampling applications where study goals require oversampling by race/ethnicity, self-reported race/ethnicity is unavailable. We describe a new method that allows oversampling on the basis of indirectly estimated race/ethnicity when name and address information are available. We adapt a Bayesian method for imputing self-reported race/ethnicity from surname and residential address information for use with marriage license application data …
Sampling with Field Burden Constraints: An Application to Sheltered Homeless and Low-Income Housed Women
In this article, the authors present a statistically efficient, cost-effective way of collecting a probability sample in the presence of certain field burden constraints: restrictions on the maximum number of participants that can be sampled within a given institution and a small population size relative to the sample size dictated by the study aims. The authors suggest the use of disproportionate stratified random sampling as an alternative to t…
Predictors of Unprotected Sex with Non-cohabitating Primary Partners among Sheltered and Low-income Housed Women in Los Angeles County
This study investigated associations of substance use, relationship abuse and HIV self-protective behavior with unprotected sex among 290 impoverished women with a non-cohabitating primary partner. Unprotected sex was associated with having a physically or psychologically abusive partner among low-income housed women, and having an abusive partner who also drank to intoxication among women living in shelters. Indicators of HIV self-protective beh…
Do Medicaid and Commercial CAHPS Scores Correlate Within Plans: A New Jersey Case Study
Background: The Consumer Assessment of Health Plans Study (CAHPS) health plan survey is currently administered to large independent samples of Medicaid beneficiaries and commercial enrollees for managed care organizations that serve both populations. There is interest in reducing survey administration costs and sample size requirements by sampling these 2 groups together for health plan comparisons. Plan managers may also be interested in underst…
Predictors of Unprotected Sex with Non-cohabitating Primary Partners among Sheltered and Low-income Housed Women in Los Angeles County
This study investigated associations of substance use, relationship abuse and HIV self-protective behavior with unprotected sex among 290 impoverished women with a non-cohabitating primary partner. Unprotected sex was associated with having a physically or psychologically abusive partner among low-income housed women, and having an abusive partner who also drank to intoxication among women living in shelters. Indicators of HIV self-protective beh…
Sampling with Field Burden Constraints: An Application to Sheltered Homeless and Low-Income Housed Women
In this article, the authors present a statistically efficient, cost-effective way of collecting a probability sample in the presence of certain field burden constraints: restrictions on the maximum number of participants that can be sampled within a given institution and a small population size relative to the sample size dictated by the study aims. The authors suggest the use of disproportionate stratified random sampling as an alternative to t…
Adolescent Participation in Preventive Health Behaviors, Physical Activity, and Nutrition: Differences Across Immigrant Generations for Asians and Latinos Compared With Whites
Objectives. We investigated preventive health behaviors (bicycle helmet, seat belt, and sunscreen use), physical activity, television viewing or video game playing, and nutrition (fruit, vegetable, milk, and soda consumption) among Asian and Latino adolescents living in the United States; assessed trends across generations (first-, second-, and third-generation immigrants or later); and compared each generation with White adolescents. Methods. We…
The Relationship Between Spanish Language Use and Substance Use Behaviors Among Latino Youth: A Social Network Approach
Use of Expert Ratings as Sampling Strata for a More Cost-Effective Probability Sample of a Rare Population
We consider situations in which externally observable characteristics allow experts to quickly categorize individual households as likely or unlikely to contain a member of a rare target population. This classification can form the basis of disproportionate stratified sampling such that households classified as "unlikely" are sampled at a lower rate than those classified as "likely," thereby reducing screening costs. Design weights account for th…
Are There Differences in the Medicare Experiences of Beneficiaries in Puerto Rico Compared with Those in the U.S. Mainland
BACKGROUND: Little is known about the healthcare experiences of Medicare beneficiaries in Puerto Rico. OBJECTIVES: We compare the experiences of elderly Medicare beneficiaries in Puerto Rico with their English-preferring and Spanish-preferring Medicare counterparts in the U.S. mainland. RESEARCH DESIGN: Linear regression models compared mean Consumer Assessment of Healthcare Providers and Systems scores for these groups, using cross-sectional dat…
Racial/Ethnic Disparities in Medicare Part D Experiences
OBJECTIVE: To examine racial/ethnic differences in Medicare beneficiary experiences with Medicare Part D prescription drug (PD) coverage. DATA SOURCES/STUDY SETTING: 2008 Consumer Assessment of Health Care Providers and Systems survey of U.S. Medicare beneficiaries. STUDY DESIGN: Surveys were administered by mail with phone follow-up to a nationally representative sample (61% response rate). This study examines 201,496 beneficiaries of age 65 and…
Using Indirect Estimates Based on Name and Census Tract to Improve the Efficiency of Sampling Matched Ethnic Couples from Marriage License Data
For many sampling applications where study goals require oversampling by race/ethnicity, self-reported race/ethnicity is unavailable. We describe a new method that allows oversampling on the basis of indirectly estimated race/ethnicity when name and address information are available. We adapt a Bayesian method for imputing self-reported race/ethnicity from surname and residential address information for use with marriage license application data …
Diabetes and Cardiovascular Disease Risk in Cambodian Refugees
Racial/Ethnic Disparities in Medicare Beneficiaries’ Care Coordination Experiences
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 responde…
Indirect Estimation of Race/Ethnicity for Survey Respondents Who Do Not Report Race/Ethnicity
It may be worthwhile to impute race/ethnicity when this information is unavailable in survey data sets due to item nonresponse, especially when missingness is high
Disparities in Care Experienced by American Indian and Alaska Native Medicare Beneficiaries
BACKGROUND: Little is known about the health care experiences of American Indians and Alaska Natives (AIANs) due to limited data. OBJECTIVE: The objective of this study was to investigate the health care experiences of AIAN Medicare beneficiaries relative to non-Hispanic Whites using national survey data pooled over 5 years. SUBJECTS: A total of 1,193,248 beneficiaries who responded to the nationally representative 2012-2016 Medicare Consumer Ass…
Patient Experience for Hispanic Older Adults Varies by Language Preference
BACKGROUND: Hispanic people with Medicare report worse patient experiences than non-Hispanic White counterparts. However, little research examines how these disparities may vary by language preference (English/Spanish). OBJECTIVES: Using Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey data, assess whether 2014-2018 disparities in patient experiences for Hispanic people with Medicare vary by language preference. RES…
Disparities in Care Experienced by Older Hispanic Medicare Beneficiaries in Urban and Rural Areas
BACKGROUND: Hispanic older adults face substantial health disparities compared with non-Hispanic-White (hereafter "White") older adults. To the extent that these disparities stem from cultural and language barriers faced by Hispanic people, they may be compounded by residence in rural areas. OBJECTIVE: The objective of this study was to investigate possible interactions between Hispanic ethnicity and rural residence in predicting the health care …
Measuring Inconsistency in Quality Across Patient Groups to Target Quality Improvement
BACKGROUND: Quality improvement (QI) may be aimed at improving care for all patients, or it may be targeted at only certain patient groups. Health care providers have little guidance when determining when targeted QI may be preferred. OBJECTIVES: The aim was to develop a method for quantifying performance inconsistency and guidelines for when inconsistency indicates targeted QI, which we apply to the performance of health plans for different pati…
Measuring Equity in the Hospital Setting: An HCAHPS Application of the Health Equity Summary Score
BACKGROUND: Health care quality varies by patient factors, including race-and-ethnicity and preferred language. Addressing inequities requires identifying them and incentivizing equity. OBJECTIVES: We apply an approach first implemented in the Medicare Advantage setting to measure equity in patient experiences by race-and-ethnicity [Asian American and Native Hawaiian or Pacific Islander (AA and NHPI), Black, Hispanic, vs. White] and language pref…
Survey Protocols, Response Rates, and Representation of Underserved Patients: A Randomized Clinical Trial
In this randomized clinical trial, web-first multimode survey protocols significantly improved the RR and representativeness of patient surveys. The best-performing protocol based on RR and representativeness was web-mail-phone. Web-phone performed well for young and diverse patient populations, and web-mail for older and less diverse patient populations. The US Centers for Medicare & Medicaid Services will allow hospitals to use the web-mail, we…
Mixed Mode Substantially Increases Hospital Consumer Assessment of Healthcare Providers and Systems Response Rates Relative to Single-Mode Protocols
BACKGROUND: Low response rates (RRs) can affect hospitals' data collection costs for patient experience surveys and value-based purchasing eligibility. Most hospitals use single-mode approaches, even though sequential mixed mode (MM) yields higher RRs and perhaps better patient representativeness. Some hospitals may be reluctant to incur MM's potential additional cost and complexity without knowing how much RRs would increase. OBJECTIVE: The aim …
Do Hospital Characteristics Predict Racial-and-Ethnic Disparities in Patient Experience? National Results From the HCAHPS Survey
OBJECTIVE: Assess whether hospital characteristics associated with better patient experiences overall are also associated with smaller racial-and-ethnic disparities in inpatient experience. BACKGROUND: Hospitals that are smaller, non-profit, and serve high proportions of White patients tend to be high-performing overall, but it is not known whether these hospitals also have smaller racial-and-ethnic disparities in care. RESEARCH DESIGN: We used l…
Comparison of Alternative Approaches to Using Race-and-Ethnicity Data in Estimating Differences in Health Care and Social Determinants of Health
OBJECTIVE: The objective of this study was to compare 2 approaches for representing self-reported race-and-ethnicity, additive modeling (AM), in which every race or ethnicity a person endorses counts toward measurement of that category, and a commonly used mutually exclusive categorization (MEC) approach. The benchmark was a gold-standard, but often impractical approach that analyzes all combinations of race-and-ethnicity as distinct groups. METH…
Supplemental Items Reduce HCAHPS Response Rates, but Response Rates Do Not Affect HCAHPS Scores: A Randomized Experiment
BACKGROUND: Longer surveys can reduce response rates (RRs). Observational data suggest a positive hospital-level association between RRs and HCAHPS scores, but a negative patient-level relationship. There is no experimental evidence of whether a hospital's RR affects its HCAHPS scores. OBJECTIVES: Estimate the effect of the 59-item versus 32-item survey on RR by survey mode; assess whether any reductions in RR change HCAHPS scores. RESEARCH DESIG…
Evaluation of Proposed New Measures for the Hospital CAHPS Survey
Background: Since its 2006 launch, the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey has become the most used hospital patient experience survey, included in public reporting and accountability systems. Responding to emerging evidence of possible gaps in survey content, the Centers for Medicare & Medicaid Services undertook extensive efforts to develop and test new HCAHPS measures. Objectives: Describe the devel…
Updated Adjustment of the HCAHPS Survey for New Modes of Survey Administration and Patient Mix
BACKGROUND: Web-first multimode survey protocols increase Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey response rates and representativeness but may result in different HCAHPS scores because of survey mode effects and selective email address availability. A variable absent from many patient-mix adjustment models that may result in more positive patient experiences is whether the hospital admission was planned; …
Medicine (17 works) · Ethnic group (12 works) · Psychology (11 works) · Patient Satisfaction in Healthcare (10 works) · Gerontology (9 works) · Demography (8 works) · Health care (8 works) · Healthcare Policy and Management (8 works) · Nursing (8 works) · Gerontology (7 works)