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Medical Care Research and Review
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What's this?

Problem-Oriented Reporting of CAHPS Consumer Evaluations of Health Care

Marc N. Elliott

RAND, Elliott{at}rand.org

Megan K. Beckett

RAND, Megan_Beckett{at}rand.org

David E. Kanouse

RAND, David_Kanouse{at}rand.org

Katrin Hambarsoomians

RAND, Katrin_Hambarsoomians{at}rand.org

Shulamit Bernard

RTI International, sbernard{at}rti.org

Consumer Assessment of Health Care Providers and Systems (CAHPS) is an organized effort to provide consumers with standardized, comprehensible, and usable data regarding consumers' experiences with health care. In its Medicare and other summary reports, CAHPS emphasizes the frequency of the most positive experiences. Cognitive models of survey response combined with attitude theory suggest that performance measurement might be further improved by the addition of problem-oriented reporting, which highlights the frequency of negative experiences. We propose criteria and use them to assess whether problem-oriented reporting provides valid, precise, and complementary information. Analysis of the 2000 CAHPS Medicare Fee-For-Service and 2001 CAHPS Medicare Advantage survey data shows that problem-oriented reporting (1) is viable, interpretable, and unlikely to represent noise; (2) has statistical power sufficient to capture important differences of magnitudes commonly observed; and (3) provides information that complements standard reporting.

Key Words: health care surveys • quality of health care • consumer satisfaction • quality indicator • data reporting • scoring method

This version was published on October 1, 2007

Medical Care Research and Review, Vol. 64, No. 5, 600-614 (2007)
DOI: 10.1177/1077558707304632


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