Contribution of HCAHPS Specific Care Experiences to Global Ratings Varies Across 7 Countries

BACKGROUND: Given the increased international interest in improvement strategies for patient experiences with care, it is important to understand whether the same specific care experiences affect global ratings across countries. Moreover, reporting of these global ratings currently substantially varies in both research and public reporting. OBJECTIVES: The objectives of this study were to examine the differential magnitude of associations between Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) specific care experiences and global ratings, and to explore implications for reporting these global ratings. METHODS: HCAHPS data were collected from 11,289 patients across 7 European countries. We studied the association between 11 experience items and 2 global ratings (0-10 hospital rating, hospital recommendation) using multilevel ordered logistic regression analysis. Using interaction terms, we examined consistency of these associations across countries. Assuming homogeneous use and interpretations of response categories of these specific experiences across patients within and between countries, we investigated what the associations between specific experiences and global ratings imply for reporting global ratings across countries. RESULTS: All specific experiences were associated with both global ratings. "Being talked to about care after leaving the hospital" showed the strongest association. There were relatively little differential effects across countries. A reporting strategy with different cutpoints across countries might provide a more equitable comparison of global ratings. CONCLUSIONS: Our findings highlight a differential contribution of HCAHPS specific experiences to overall ratings across countries. Research and public reporting may consider examining in more detail within and across populations global rating cutpoints that represent the same true level of positive patient experiences

Affect (linguistics) · Consistency (knowledge bases) · Differential (mechanical device) · Family medicine · Global health · Health care · Logistic regression · MEDLINE · Multilevel model · Political science · Public health · Statistics · Healthcare Policy and Management · Medicine · Nursing · Patient Satisfaction in Healthcare · Primary Care and Health Outcomes · Psychology

• Statistical Analysis With Missing Data

  Maureen Lahiff, Roderick J A Little et al.•Journal of the American…•1989

  Incluir item

• Patient safety, satisfaction, and quality of hospital care

  Open Access•Linda H Aiken, Walter Sermeus et al.•BMJ•2012

  Incluir item

• The cost of dichotomising continuous variables

  Open Access•David G Altman, Douglas G Altman et al.•BMJ•2006

  Incluir item

• Comparability of self rated health

  Open Access•Joshua A Salomon•BMJ•2004

  Incluir item

• Regression Models for Ordinal Data

  Open Access•Peter McCullagh•Journal of the Royal Statistical…•1980

  Incluir item

• Differential Item Functioning Results May Change Depending On How An Item Is Scored

  Open Access•Michaela N Gelin, Bruno D Zumbo•Educational and Psychological…•2003

  Incluir item

• Promises and Pitfalls of Anchoring Vignettes in Health Survey Research

  Open Access•Hanna Grol-Prokopczyk, Emese Verdes-Tennant et al.•Demography•2015

  Incluir item

• Associations of CAHPS Composites With Global Ratings of the Doctor Vary by Medicare Beneficiaries’ Health Status

  Ron D Hays, Joshua S Mallett et al.•Medical Care•2018

  Incluir item

• Impact of Cross-level Measurement Noninvariance on Hospital Rankings Based on Patient Experiences With Care in 7 European Countries

  Benedict O Orindi, Benedict Orindi et al.•Medical Care•2017

  Incluir item

• Do Differential Response Rates to Patient Surveys Between Organizations Lead to Unfair Performance Comparisons

  Catherine L Saunders, Marc N Elliott et al.•Medical Care•2016

  Incluir item

• Racial/Ethnic Disparities in Patient Experience With Communication in Hospitals

  Junya Zhu, Saul N Weingart et al.•Medical Care•2015

  Incluir item

• Survey Response Style and Differential Use of CAHPS Rating Scales by Hispanics

  Robert Weech-Maldonado, Marc N Elliott et al.•Medical Care•2008

  Incluir item

• Patient Judgments of Hospital Quality A Taxonomy

  Mark Meterko, Haya R Rubin•Medical Care•1990

  Incluir item

• Components of Care Vary in Importance for Overall Patient-Reported Experience by Type of Hospitalization

  Marc N Elliott, David E Kanouse et al.•Medical Care•2009

  Incluir item

• Enhancing the Validity and Cross-Cultural Comparability of Measurement in Survey Research

  Open Access•Gary King, Christopher J L Murray et al.•American Political Science Review•2004

  Incluir item