National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Ambulatory Care and Surgery (1)
- Burnout (1)
- Children/Adolescents (3)
- Clinician-Patient Communication (3)
- Communication (1)
- (-) Consumer Assessment of Healthcare Providers and Systems (CAHPS) (19)
- Cultural Competence (1)
- Diabetes (1)
- Disparities (2)
- Education: Patient and Caregiver (1)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (1)
- Hospitals (7)
- Inpatient Care (1)
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- Medical Expenditure Panel Survey (MEPS) (1)
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- Medication (1)
- Organizational Change (1)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (1)
- Patient and Family Engagement (1)
- Patient Experience (13)
- Payment (1)
- Practice Improvement (1)
- Primary Care (3)
- Provider (1)
- Provider: Clinician (1)
- Provider: Health Personnel (1)
- Provider: Nurse (1)
- Provider: Physician (1)
- Provider Performance (4)
- Public Reporting (1)
- Quality Improvement (5)
- Quality Measures (3)
- Quality of Care (15)
- Racial and Ethnic Minorities (4)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 19 of 19 Research Studies DisplayedQuigley DD, Elliott MN, Slaughter ME
Shadow coaching improves patient experience with care, but gains erode later.
Health care organizations strive to improve patient care experiences. Some use one-on-one provider counseling (shadow coaching) to identify and target modifiable provider behaviors. In this study, the investigators examined whether shadow coaching improved patient experience across 44 primary care practices in a large urban Federally Qualified Health Center. The investigators concluded that shadow coaching improved providers' overall performance and communication immediately after being coached.
AHRQ-funded; HS025920.
Citation: Quigley DD, Elliott MN, Slaughter ME .
Shadow coaching improves patient experience with care, but gains erode later.
Med Care 2021 Nov;59(11):950-60. doi: 10.1097/mlr.0000000000001629..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Provider Performance, Quality Improvement, Quality of Care, Primary Care
Roberts ET, Song Z, Ding L
Changes in patient experiences and assessment of gaming among large clinician practices in precursors of the merit-based incentive payment system.
Medicare's Merit-Based Incentive Payment System (MIPS), a public reporting and pay-for-performance program, adjusts clinician payments based on publicly reported measures that are chosen primarily by clinicians or their practices. Within precursor programs of the MIPS, this study examined 1) practices' selection of Consumer Assessment of Healthcare Providers and Systems (CAHPS) patient experience measures for quality scoring under pay-for-performance and 2) the association between mandated public reporting on CAHPS measures and performance on those measures.
AHRQ-funded; HS026727.
Citation: Roberts ET, Song Z, Ding L .
Changes in patient experiences and assessment of gaming among large clinician practices in precursors of the merit-based incentive payment system.
JAMA Health Forum 2021 Oct;2(10). doi: 10.1001/jamahealthforum.2021.3105..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Medicare, Provider Performance, Payment, Quality Improvement, Quality of Care
Fowler FJ, Brenner PS, Hargraves JL
Comparing web and mail protocols for administering Hospital Consumer Assessment of Healthcare Providers and Systems surveys.
This study’s objective was to compare results of using web-based and mail HCAHPS data collection protocols. The cohort included patients who were hospitalized in a New England Hospital. Patients who provided email addresses were randomized to 1 of 3 data collection protocols: web-only, web with postal mail follow-up, and postal mail only. Those who did not provide email addresses were surveyed by postal mail only. The study lasted 8 weeks. Measures looked at included response rates, characteristics of respondents, 6 composite measures of their patient experiences, and two ratings of the hospital. Web-only response rates were significantly lower than for mail or combined protocols, and those who had not provided email addresses also had lower response rates. Older adults over age 65 were more likely to respond to all protocols, especially for mail-only respondents. Respondents without email addresses were older, less educated, and reported worse health than those who had email addresses.
AHRQ-funded; HS016978.
Citation: Fowler FJ, Brenner PS, Hargraves JL .
Comparing web and mail protocols for administering Hospital Consumer Assessment of Healthcare Providers and Systems surveys.
Med Care 2021 Oct;59(10):907-12. doi: 10.1097/mlr.0000000000001627..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Health Information Technology (HIT), Quality Measures, Provider Performance, Quality of Care
Prasad T, Buta E, Cleary PD
Is patient-physician gender concordance related to the quality of patient care experiences?
There is great interest in identifying factors that are related to positive patient experiences such as physician communication style. Documented gender-specific physician communication and patient behavior differences raise the question of whether gender concordant relationships (i.e., both the provider and patient share the same gender) might affect patient experiences. The objective of this study was to assess whether patient experiences were more positive in gender concordant primary care relationships.
AHRQ-funded; HS016978.
Citation: Prasad T, Buta E, Cleary PD .
Is patient-physician gender concordance related to the quality of patient care experiences?
J Gen Intern Med 2021 Oct;36(10):3058-63. doi: 10.1007/s11606-020-06411-y..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience
Quigley DD, Slaughter ME, Gidengil C
Usefulness of child HCAHPS survey data for improving inpatient pediatric care experiences.
Quality improvement (QI) requires data, indicators, and national benchmarks. Knowledge about the usefulness of Child Hospital Consumer Assessment of Healthcare Providers and Systems (Child HCAHPS) data are lacking. In this study the investigators examined quality leader and frontline staff perceptions about patient experience measurement and use of Child HCAHPS data for QI. The investigators surveyed children's hospital leaders and staff about their use of Child HCAHPS for QI, including measures from other studies. They compared scale and item means for leaders and staff and compared means to other studies.
AHRQ-funded; HS025920.
Citation: Quigley DD, Slaughter ME, Gidengil C .
Usefulness of child HCAHPS survey data for improving inpatient pediatric care experiences.
Hosp Pediatr 2021 Oct;11(10):e199-e214. doi: 10.1542/hpeds.2020-004283..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Children/Adolescents, Hospitals, Patient Experience, Quality Improvement, Quality Measures, Quality of Care
Quigley DD, Qureshi N, AlMasarweh L
Using CAHPS patient experience data for patient-centered medical home transformation.
The purpose of this study was to examine how primary care practices used the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey and its patient-centered medical home (PCMH) items during their PCMH transition. The investigators concluded that CAHPS surveys were considered actionable for PCMH transformation and used in standardizing and coordinating care. The CAHPS PCMH items were considered integral to the continuous QI needed for moving beyond formal PCMH recognition and maximizing transformation.
AHRQ-funded; HS016980; HS025920.
Citation: Quigley DD, Qureshi N, AlMasarweh L .
Using CAHPS patient experience data for patient-centered medical home transformation.
Am J Manag Care 2021 Sep;27(9):e322-e29. doi: 10.37765/ajmc.2021.88745..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Patient-Centered Healthcare, Primary Care, Practice Improvement, Healthcare Delivery, Quality Improvement, Quality of Care
Meyers DJ, Rahman M, Mor V
Association of Medicare Advantage Star Ratings with racial, ethnic, and socioeconomic disparities in quality of care.
This cross-sectional study looked at racial/ethnic minority and socioeconomic disparities in ratings for Medicare Advantage (MA) plans, which disproportionately enroll these populations. A total of 1,578,564 enrollees were included in this analysis that used 22 measures of quality and satisfaction at the individual enrollee level, aggregated into simulated star ratings from 2-5 stratified by socioeconomic status (SES) and race/ethnicity. Low SES enrollees had simulated stratified star ratings 0.5 stars lower than individuals with high SES in the same contract. Black enrollees had simulated star ratings that were 0.3 stars lower and Hispanic enrollees had 0.1 lower simulated star ratings than White enrollees in the same contract. There was a larger difference in ratings with 4.5 to 5-star contracts with Black and Hispanic enrollees with Whites, and no statistical difference in 2.0 to 2.5 star-rated contracts. There was only low correlation between simulated ratings for enrollees of low SES and high SES.
AHRQ-funded; HS02705101.
Citation: Meyers DJ, Rahman M, Mor V .
Association of Medicare Advantage Star Ratings with racial, ethnic, and socioeconomic disparities in quality of care.
JAMA Health Forum 2021 Jun;2(6):e210793..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Medicare, Patient Experience, Disparities, Quality Measures, Provider Performance, Quality of Care, Racial and Ethnic Minorities
Chatterjee P, Qi M, Werner RM
Association of Medicaid expansion with quality in safety-net hospitals.
The authors compared changes in quality from 2012 to 2018 between safety net hospitals (SNHs) in states that expanded Medicaid vs those in states that did not. They found that, despite reductions in uncompensated care and improvements in operating margins, there appeared to be little evidence of quality improvement among SNHs in states that expanded Medicaid compared with those in states that did not.
AHRQ-funded; HS024266.
Citation: Chatterjee P, Qi M, Werner RM .
Association of Medicaid expansion with quality in safety-net hospitals.
JAMA Intern Med 2021 May;181(5):590-97. doi: 10.1001/jamainternmed.2020.9142..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Medicaid, Quality Improvement, Quality of Care
Willard-Grace R, Knox M, Huang B
Primary care clinician burnout and engagement association with clinical quality and patient experience.
Burnout and engagement are commonly conceptualized as opposite ends of a spectrum, and there is concern that high clinician burnout and lack of engagement may adversely impact patient care. In this study, the investigators matched self-reported data on burnout and engagement for 182 primary care clinicians with data on clinical quality (cancer screenings, hypertension and diabetes control) and patient experience (Clinician and Group Survey-Consumer Assessment of Healthcare Providers and Systems [CG-CAHPS] communication scores, overall rating, and likelihood to recommend the clinic).
AHRQ-funded; HS026067.
Citation: Willard-Grace R, Knox M, Huang B .
Primary care clinician burnout and engagement association with clinical quality and patient experience.
J Am Board Fam Med 2021 May-Jun;34(3):542-52. doi: 10.3122/jabfm.2021.03.200515..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Burnout, Patient Experience, Patient and Family Engagement, Provider: Clinician, Provider: Physician, Quality of Care, Provider: Nurse, Provider: Health Personnel
Kirby JB, Berdahl TA, Stone RA
AHRQ Author: Kirby JB, Berdahl TA
Perceptions of patient-provider communication across the six largest Asian subgroups in the USA.
Investigators sought to estimate racial/ethnic differences in perceptions of provider communication among the six largest Asian subgroups. Using MEPS data, they found that negative views of provider communication are not pervasive among all Asians but, rather, primarily reflect the perceptions of Chinese and, possibly, Vietnamese patients. They recommended that researchers, policymakers, health plan executives, and others who produce or use data on patients' experiences with health care avoid categorizing all Asians into a single group.
AHRQ-authored.
Citation: Kirby JB, Berdahl TA, Stone RA .
Perceptions of patient-provider communication across the six largest Asian subgroups in the USA.
J Gen Intern Med 2021 Apr;36(4):888-93. doi: 10.1007/s11606-020-06391-z..
Keywords: Medical Expenditure Panel Survey (MEPS), Consumer Assessment of Healthcare Providers and Systems (CAHPS), Clinician-Patient Communication, Communication, Patient Experience, Racial and Ethnic Minorities, Cultural Competence
Ahmedov M, Pourat N, Liu H
Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey of experiences with ambulatory healthcare for Asians and non-Hispanic Whites in the United States.
This paper discusses the results of the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Clinical and Group (CG-CAHPS) Adult Visit Survey 1.0 which includes data on care experiences to compare specific aspects of care of Asians and Whites. Most surveys were administered by mail with a sample comprised of 64% female, 89% White, 2% Asian, 39% 65 years or older, and 32% were high school graduates or less. Asians reported worse access, lower scores on office staff courtesy and helpfulness and rating their doctors, and were less likely to recommend their doctors to family/friends than did Whites.
AHRQ-funded; HS016980; HS016978.
Citation: Ahmedov M, Pourat N, Liu H .
Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey of experiences with ambulatory healthcare for Asians and non-Hispanic Whites in the United States.
J Patient Rep Outcomes 2021 Mar 24;5(1):29. doi: 10.1186/s41687-021-00303-3..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Racial and Ethnic Minorities, Patient Experience, Quality of Care, Ambulatory Care and Surgery
Elliott MN, Cohea CW, Lehrman WG
Accelerating improvement and narrowing gaps: trends in patients' experiences with hospital care reflected in HCAHPS public reporting.
The researchers describe the experiences of over 4 million patients discharged from hospitals that participated in the second and fifth years of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) public reporting and assess the changes in HCAHPS scores across different types of hospital and patient groups. They found that HCAHPS scores increased by 2.8 percentage points from 2008 to 2011 in the most positive response category.
AHRQ-funded; HS016978.
Citation: Elliott MN, Cohea CW, Lehrman WG .
Accelerating improvement and narrowing gaps: trends in patients' experiences with hospital care reflected in HCAHPS public reporting.
Health Serv Res 2015 Dec;50(6):1850-67. doi: 10.1111/1475-6773.12305..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Quality of Care, Public Reporting
Aboumatar HJ, Chang BH, Danaf J
Promising practices for achieving patient-centered hospital care: a national study of high-performing US hospitals.
The researchers conducted a national study of hospitals that achieved the highest performance on Hospital Consumer Assessment of Healthcare Providers and Systems HCAHPS to identify promising practices for improving patient-centeredness, common challenges met, and how those were addressed. They found that high-performing hospitals used a set of patient-centered care processes that involved both leaders and clinicians in ensuring that patient needs and preferences are addressed.
AHRQ-funded; HS021921.
Citation: Aboumatar HJ, Chang BH, Danaf J .
Promising practices for achieving patient-centered hospital care: a national study of high-performing US hospitals.
Med Care 2015 Sep;53(9):758-67. doi: 10.1097/mlr.0000000000000396..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Patient Experience, Quality of Care, Patient-Centered Outcomes Research
Toomey SL, Zaslavsky AM, Elliott MN
The development of a pediatric inpatient experience of care measure: Child HCAHPS.
This article describes the development of Child Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), which included a national field test with 69 hospitals in 34 States, psychometric analysis, and end-user testing of the final survey. The final Child HCAHPS instrument has 62 items, including 39 patient experience items, 10 screeners, 12 demographic/descriptive items and 1 open-ended item.
AHRQ-funded; HS020513.
Citation: Toomey SL, Zaslavsky AM, Elliott MN .
The development of a pediatric inpatient experience of care measure: Child HCAHPS.
Pediatrics 2015 Aug;136(2):360-9. doi: 10.1542/peds.2015-0966..
Keywords: Children/Adolescents, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Inpatient Care, Patient Experience, Quality of Care
Thorpe CT, Johnson H, Dopp AL
Medication oversupply in patients with diabetes.
This article describes the development of Child Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), which included a national field test with 69 hospitals in 34 States, psychometric analysis, and end-user testing of the final survey. The final Child HCAHPS instrument has 62 items, including 39 patient experience items, 10 screeners, 12 demographic/descriptive items and 1 open-ended item.
AHRQ-funded; HS000083; HS018368; HS017646.
Citation: Thorpe CT, Johnson H, Dopp AL .
Medication oversupply in patients with diabetes.
Res Social Adm Pharm 2015 May-Jun;11(3):382-400. doi: 10.1016/j.sapharm.2014.09.002..
Keywords: Medication, Diabetes, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Children/Adolescents, Hospitals
Zhu J, Weingart SN, Ritter GA
Racial/Ethnic disparities in patient experience with communication in hospitals: real differences or measurement errors?
This study examined assumptions about the degree of commonality across racial/ethnic groups in their perceptions and investigated the validity of racial/ethnic differences in communication quality. Its results provide strongest support for racial/ethnic comparisons on communication with nurses and doctors, and reason to caution against comparisons on communication about medicines due to significant differences in model parameters across groups.
AHRQ-funded; 290010003.
Citation: Zhu J, Weingart SN, Ritter GA .
Racial/Ethnic disparities in patient experience with communication in hospitals: real differences or measurement errors?
Med Care 2015 May;53(5):446-54. doi: 10.1097/mlr.0000000000000350..
Keywords: Disparities, Clinician-Patient Communication, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Racial and Ethnic Minorities, Quality of Care
Nembhard IM, Yuan CT, Shabanova V
The relationship between voice climate and patients' experience of timely care in primary care clinics.
The aims of this study were to assess the relationship between organizational climate and patients’ reports of timely care in primary care clinics and to broadly examine the link between staff’s work environment and patient care experiences. It found that clinical and administrative staff (e.g., nurses and office assistants) reported clinics’ climates to be significantly less supportive of voice than did clinical leaders (e.g., physicians).
AHRQ-funded; HS018987; HS016978.
Citation: Nembhard IM, Yuan CT, Shabanova V .
The relationship between voice climate and patients' experience of timely care in primary care clinics.
Health Care Manage Rev 2015 Apr-Jun;40(2):104-15. doi: 10.1097/hmr.0000000000000017..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Primary Care, Quality of Care, Organizational Change, Provider
Anhang Price R, Elliott MN, Cleary PD
Should health care providers be accountable for patients' care experiences?
Using evidence from the Consumer Assessment of Healthcare Providers and Systems surveys, the authors address seven common critiques of patient experience measures. These include: lack of consumer expertise, the subjectivity of patient satisfaction, and the trade-off between providing good patient experiences and providing high-quality clinical care.
AHRQ-funded; HS016980; HS016978
Citation: Anhang Price R, Elliott MN, Cleary PD .
Should health care providers be accountable for patients' care experiences?
J Gen Intern Med. 2015 Feb;30(2):253-6. doi: 10.1007/s11606-014-3111-7..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Patient Experience, Patient-Centered Healthcare
Shadel WG, Elliott MN, Haas AC
Clinician advice to quit smoking among seniors.
This study describes patterns of clinician cessation advice to US seniors, including variation by Medicare beneficiary characteristics. It found that only 51% of smokers say they receive cessation advice “always” or “usually” at doctor visits, with advice more often given to the young, those in low-smoking regions, Asians, and women.
AHRQ-funded; HS016978.
Citation: Shadel WG, Elliott MN, Haas AC .
Clinician advice to quit smoking among seniors.
Prev Med 2015 Jan;70:83-9. doi: 10.1016/j.ypmed.2014.11.020..
Keywords: Tobacco Use, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Education: Patient and Caregiver, Medicare, Clinician-Patient Communication