Experiences of Care Among Medicare Beneficiaries With ESRD: Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey Results

Paddison, Charlotte; Elliott, Marc N.; Haviland, Amelia; Farley, Donna O.; Lyratzopoulos, Georgios; Hambarsoomian, Katrin; Dembosky, Jacob W.; Roland, Martín

doi:10.1053/j.ajkd.2012.10.009

Cited by 49 publications

(39 citation statements)

References 29 publications

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“…This is consistent with findings from research showing that patients with diabetes in the U.S. generally report a more positive experience of care than those without diabetes (22). However, we also found important evidence of differences in the primary care experiences for diabetes patients with comorbid conditions.…”

Section: Discussionsupporting

confidence: 90%

“…Our study builds on what is known within a U.S. context about health care experiences among people with diabetes (28) and those with complications often arising from diabetes (22) by investigating the experience of people with diabetes in a U.K. setting in which a national health system with universal coverage enables access to free healthcare for all residents. Particular strengths of our study are the large sample size, our analysis of the impact of comorbidity, and our ability to investigate how the experiences of people with diabetes vary by sociodemographic characteristics and health status.…”

Section: Primary Care Experiences Among People With Diabetes Vary By mentioning

confidence: 99%

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How Do People With Diabetes Describe Their Experiences in Primary Care? Evidence From 85,760 Patients With Self-reported Diabetes From the English General Practice Patient Survey

et al. 2014

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OBJECTIVEDeveloping primary care is an important current health policy goal in the U.S. and England. Information on patients' experience can help to improve the care of people with diabetes. We describe the experiences of people with diabetes in primary care and examine how these experiences vary with increasing comorbidity. RESEARCH DESIGN AND METHODSUsing data from 906,578 responders to the 2012 General Practice Patient Survey (England), including 85,760 with self-reported diabetes, we used logistic regressions controlling for age, sex, ethnicity, and socioeconomic status to analyze patient experience using seven items covering three domains of primary care: access, continuity, and communication. RESULTSPeople with diabetes were significantly more likely to report better experience on six out of seven primary care items than people without diabetes after adjusting for age, sex, ethnicity, and socioeconomic status (adjusted differences 0.88-3.20%; odds ratios [ORs] 1.07-1.18; P < 0.001). Those with diabetes and additional comorbid long-term conditions were more likely to report worse experiences, particularly for access to primary care appointments (patients with diabetes alone compared with patients without diabetes: OR 1.22 [95% CI 1.17-1.28] and patients with diabetes plus three or more conditions compared with patients without diabetes: OR 0.87 [95% CI 0.83-0.91]). CONCLUSIONSPeople with diabetes in England report primary care experiences that are at least as good as those without diabetes for most domains of care. However, improvements in primary care are needed for diabetes patients with comorbid long-term conditions, including better access to appointments and improved communication.

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Section: Discussionsupporting

confidence: 90%

Section: Primary Care Experiences Among People With Diabetes Vary By mentioning

confidence: 99%

How Do People With Diabetes Describe Their Experiences in Primary Care? Evidence From 85,760 Patients With Self-reported Diabetes From the English General Practice Patient Survey

et al. 2014

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“…An evaluation of the CAHPS Medicare survey for patients with ESRD conducted in 2009-2010 was recently reported (12). The cohort included 3794 patients with ESRD drawn from a database of 823,564 Medicare beneficiaries.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Consumer Assessment of Healthcare Providers and Systems In-Center Hemodialysis Survey

Wood

Paoli

Taylor‐Stokes

et al. 2014

Clinical Journal of the American Society of Nephrology

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Background and objectives The US Centers for Medicare and Medicaid Services (CMS) End Stage Renal Disease Prospective Payment System and Quality Incentive Program requires that dialysis centers meet predefined criteria for quality of patient care to ensure future funding. The CMS selected the Consumer Assessment of Healthcare Providers and Systems In-Center Hemodialysis (CAHPS-ICH) survey for the assessment of patient experience of care. This analysis evaluated the psychometric properties of the CAHPS-ICH survey in a sample of hemodialysis patients.Design, setting, participants, & measurements Data were drawn from the Adelphi CKD Disease Specific Program (a retrospective, cross-sectional survey of nephrologists and patients). Selected United States-based nephrologists treating patients receiving hemodialysis completed patient record forms and provided information on their dialysis center. Patients (n=404) completed the CAHPS-ICH survey (comprising 58 questions) providing six scores for the assessment of patient experience of care. CAHPS-ICH item-scale convergence, discrimination, and reliability were evaluated for multi-item scales. Floor and ceiling effects were estimated for all six scores. Patient (demographics, dialysis history, vascular access method) and facility characteristics (size, ratio of patients-tophysicians, nurses, and technicians) associated with the CAHPS-ICH scores were also evaluated.Results Item-scale correlations and internal consistency reliability estimates provided support for the nephrologists' communication (range, 0.16-0.71; a=0.81) and quality of care (range, 0.16-0.76; a=0.90) composites. However, the patient information composite had low internal consistency reliability (a=0.55). Provider-topatient ratios (range, 2.37 for facilities with .36 patients per physician to 2.8 for those with ,8 patients per physician) and time spent in the waiting room (3.44 for .15 minutes of waiting time to 3.75 for 5 to ,10 minutes) were characteristics most consistently related to patients' perceptions of dialysis care.Conclusions CAHPS-ICH is a potentially valuable and informative tool for the evaluation of patients' experiences with dialysis care. Additional studies are needed to estimate clinically meaningful differences between care providers.

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“…Mean response rates to recent CAHPS surveys ranged from 34 % to 61 %. 4,22 A metaanalysis of studies of nonresponse bias found no consistent relationship between a survey's nonresponse rate and nonresponse bias. 23 Nevertheless, it is important to be aware of the possibility of bias and use available information to adjust results so that nonresponse does not result in biased comparisons.…”

Section: Patient Experience Scores May Be Confounded By Factorsmentioning

confidence: 99%

Should Health Care Providers be Accountable for Patients’ Care Experiences?

Price

Elliott

Cleary³

et al. 2014

J GEN INTERN MED

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Measures of patients' care experiences are increasingly used as quality measures in accountability initiatives. As the prominence and financial impact of patient experience measures have increased, so too have concerns about the relevance and fairness of including them as indicators of health care quality. Using evidence from the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) surveys, the most widely used patient experience measures in the United States, we address seven common critiques of patient experience measures: (1) consumers do not have the expertise needed to evaluate care quality; (2) patient "satisfaction" is subjective and thus not valid or actionable; (3) increasing emphasis on improving patient experiences encourages health care providers and plans to fulfill patient desires, leading to care that is inappropriate, ineffective, and/or inefficient; (4) there is a trade-off between providing good patient experiences and providing high-quality clinical care; (5) patient scores cannot be fairly compared across health care providers or plans due to factors beyond providers' control; (6) response rates to patient experience surveys are low, or responses reflect only patients with extreme experiences; and (7) there are faster, cheaper, and more customized ways to survey patients than the standardized approaches mandated by federal accountability initiatives.

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Experiences of Care Among Medicare Beneficiaries With ESRD: Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey Results

Cited by 49 publications

References 29 publications

How Do People With Diabetes Describe Their Experiences in Primary Care? Evidence From 85,760 Patients With Self-reported Diabetes From the English General Practice Patient Survey

How Do People With Diabetes Describe Their Experiences in Primary Care? Evidence From 85,760 Patients With Self-reported Diabetes From the English General Practice Patient Survey

Evaluation of the Consumer Assessment of Healthcare Providers and Systems In-Center Hemodialysis Survey

Should Health Care Providers be Accountable for Patients’ Care Experiences?

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