National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Ambulatory Care and Surgery (1)
- Burnout (1)
- Children/Adolescents (2)
- Clinician-Patient Communication (3)
- Community-Based Practice (1)
- (-) Consumer Assessment of Healthcare Providers and Systems (CAHPS) (23)
- Decision Making (1)
- Diabetes (1)
- Disparities (2)
- Education: Continuing Medical Education (1)
- Education: Patient and Caregiver (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Health Status (1)
- Hospitals (6)
- Inpatient Care (1)
- Medicare (3)
- Medication (1)
- Nursing (1)
- Nursing Homes (1)
- Organizational Change (1)
- Patient-Centered Healthcare (4)
- Patient-Centered Outcomes Research (1)
- Patient and Family Engagement (2)
- Patient Experience (15)
- Patient Safety (1)
- Primary Care (2)
- Provider (1)
- Public Reporting (3)
- Quality Improvement (4)
- Quality Indicators (QIs) (1)
- Quality Measures (2)
- Quality of Care (15)
- Racial and Ethnic Minorities (2)
- Tobacco Use (1)
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 23 of 23 Research Studies DisplayedMartsolf GR, Gibson TB, Benevent R
AHRQ Author: Jiang HJ, Stocks C
An examination of hospital nurse staffing and patient experience with care: Differences between cross-sectional and longitudinal estimates.
The researchers studied the association between hospital nurse staffing and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. After controlling for unobserved hospital characteristics, they found that the positive influences of increased nurse staffing levels and skill mix were relatively small in size and limited to a few measures of patients' inpatient experience.
AHRQ-authored.
Citation: Martsolf GR, Gibson TB, Benevent R .
An examination of hospital nurse staffing and patient experience with care: Differences between cross-sectional and longitudinal estimates.
Health Serv Res 2016 Dec;51(6):2221-41. doi: 10.1111/1475-6773.12462.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Nursing, Patient Experience, Patient Experience, Healthcare Cost and Utilization Project (HCUP)
Melnick ER, Powsner SM
Empathy in the time of burnout.
The authors argue that before adding empathy measurements to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, it would be wise to consider that measurement fatigue contributes to burnout. Adding empathy measurements might reduce empathy: a perverse Hawthorne effect. A health care system hoping for more substantial physician-patient relationships must invest more in the well-being of its caregivers.
AHRQ-funded; HS021271.
Citation: Melnick ER, Powsner SM .
Empathy in the time of burnout.
Mayo Clin Proc 2016 Dec;91(12):1678-79. doi: 10.1016/j.mayocp.2016.09.003.
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Keywords: Burnout, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Patient Experience
Rajaram R, Saddat L, Chung J
Impact of the 2011 ACGME resident duty hour reform on hospital patient experience and processes-of-care.
The investigators evaluated the association between resident duty hour reform and measures of processes-of-care and patient experience. They concluded that the 2011 Accreditation Council for Graduate Medical Education duty hour reform was not associated with improvements in process-of-care and patient experience measures.
AHRQ-funded; HS000078.
Citation: Rajaram R, Saddat L, Chung J .
Impact of the 2011 ACGME resident duty hour reform on hospital patient experience and processes-of-care.
BMJ Qual Saf 2016 Dec;25(12):962-70. doi: 10.1136/bmjqs-2015-004794.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Education: Continuing Medical Education, Quality of Care, Patient Experience, Patient Safety
Bilimoria KY, Barnard C
The new CMS Hospital Quality Star Ratings: the stars are not aligned.
This viewpoint paper discussed the Overall Hospital Quality Star Ratings, released by the Centers for Medicare and Medicaid Services, including issues concerning stakeholders. The authors recommended continuing vigorous work to improve the availability of meaningful measures. They concluded that current hospital rating systems do not provide comprehensive, relevant, accessible information, and current composites may mislead patients, payers, and hospitals; however, opportunities to provide meaningful hospital quality report cards are within reach.
AHRQ-funded; HS021857; HS024516.
Citation: Bilimoria KY, Barnard C .
The new CMS Hospital Quality Star Ratings: the stars are not aligned.
JAMA 2016 Nov 1;316(17):1761-62. doi: 10.1001/jama.2016.13679.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Hospitals, Quality Improvement, Quality Measures
Dorr DA, Anastas T, Ramsey K
Effect of a pragmatic, cluster-randomized controlled trial on patient experience with care: The Transforming Outcomes for Patients Through Medical Home Evaluation and reDesign (TOPMED) Study.
This study's objective is to understand whether focusing on high value elements (HVEs) would improve patient experience with care. The authors found that practices targeting HVEs showed significantly more improvement in patient experience of care. However, contemporaneous trends may have affected results, leading to declines in patient experience.
AHRQ-funded; HS017832.
Citation: Dorr DA, Anastas T, Ramsey K .
Effect of a pragmatic, cluster-randomized controlled trial on patient experience with care: The Transforming Outcomes for Patients Through Medical Home Evaluation and reDesign (TOPMED) Study.
Med Care 2016 Aug;54(8):745-51. doi: 10.1097/mlr.0000000000000552.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient-Centered Healthcare, Patient Experience
Cleary PD
Evolving concepts of patient-centered care and the assessment of patient care experiences: optimism and opposition.
Improving the infrastructure supporting certain aspects of care may have broad effects because system changes can influence multiple outcomes. Thus, rather than detract from general quality improvement efforts, making changes that facilitate patient-centered care may lead to broader improvements. There is good reason to be optimistic that our health care system will increasingly be "patient centered."
AHRQ-funded; HS016978.
Citation: Cleary PD .
Evolving concepts of patient-centered care and the assessment of patient care experiences: optimism and opposition.
J Health Polit Policy Law 2016 Aug;41(4):675-96. doi: 10.1215/03616878-3620881.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient-Centered Healthcare, Patient Experience, Quality of Care, Quality Improvement
Mukamel DB, Amin A, Weimer DL
When patients customize nursing home ratings, choices and rankings differ from the government's version.
Report cards currently published by the Centers for Medicare and Medicaid Services (CMS) offer composite quality measures, such as the one featured on the Nursing Home Compare website. Nursing Home Compare Plus is an alternative that allows patients and their families to create their own composite scores based on their own preferences and medical needs. When comparing Nursing Home Compare Plus to Medicare's five-star ratings, we found only minimal agreement on ranking of nursing homes.
AHRQ-funded; HS021844.
Citation: Mukamel DB, Amin A, Weimer DL .
When patients customize nursing home ratings, choices and rankings differ from the government's version.
Health Aff 2016 Apr;35(4):714-9. doi: 10.1377/hlthaff.2015.1340.
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Keywords: Nursing Homes, Quality of Care, Quality Indicators (QIs), Patient Experience, Consumer Assessment of Healthcare Providers and Systems (CAHPS)
Hays RD, Mallett JS, Gaillot S
Performance of the Medicare Consumer Assessment of Health Care Providers and Systems (CAHPS) physical functioning items.
This study evaluated physical functioning items in Medicare beneficiaries. It concluded that the physical functioning items target relatively easy activities, providing information for a minority of people in the sample with the lowest levels of physical functioning. Items representing higher levels of physical functioning are needed for the majority of the Medicare beneficiaries.
AHRQ-funded; HS016980.
Citation: Hays RD, Mallett JS, Gaillot S .
Performance of the Medicare Consumer Assessment of Health Care Providers and Systems (CAHPS) physical functioning items.
Med Care 2016 Feb;54(2):205-9. doi: 10.1097/mlr.0000000000000475..
Keywords: Medicare, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Health Status, Quality Improvement
Kanouse DE, Schlesinger M, Shaller D
How patient comments affect consumers' use of physician performance measures.
In order to evaluate the relationship between patient characteristics and the frequency and duration of incident steroid use, the researchers applied a 2-part hurdle model to Medicare data. Their study identified differences in predictors of frequency and duration of medication use and suggests the utility of two-part models to examine drug utilization patterns.
AHRQ-funded; HS016978; HS016980.
Citation: Kanouse DE, Schlesinger M, Shaller D .
How patient comments affect consumers' use of physician performance measures.
Med Care 2016 Jan;54(1):24-31. doi: 10.1097/mlr.0000000000000443..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Patient and Family Engagement, Patient Experience, Clinician-Patient Communication
Mayer LA, Elliott MN, Haas A
Less use of extreme response options by asians to standardized care scenarios may explain some racial/ethnic differences in CAHPS scores.
The researchers explored whether lower extreme response tendency ( ERT) is observed for Asians than whites in response to standardized vignettes depicting patient experiences of care and whether ERT might in part explain Asians reporting worse care than whites. They concluded that lower ERT in Asians may partially explain observations of lower observed mean CAHPS scores for Asians in real-world settings.
AHRQ-funded; HS016980.
Citation: Mayer LA, Elliott MN, Haas A .
Less use of extreme response options by asians to standardized care scenarios may explain some racial/ethnic differences in CAHPS scores.
Med Care 2016 Jan;54(1):38-44. doi: 10.1097/mlr.0000000000000453..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Disparities, Racial and Ethnic Minorities, Patient Experience, Patient Experience
Stucky BD, Hays RD, Edelen MO
Possibilities for shortening the CAHPS Clinician and Group Survey.
This paper explores the impact on reliability and validity of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) domain scores of reducing the numbers of items used to assess the 3 core Clinician and Group adult survey CAHPS domains (Provider Communication, Access to Care, and Courteous and Helpful Office Staff).
AHRQ-funded; HS016980.
Citation: Stucky BD, Hays RD, Edelen MO .
Possibilities for shortening the CAHPS Clinician and Group Survey.
Med Care 2016 Jan;54(1):32-7. doi: 10.1097/mlr.0000000000000452..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Ambulatory Care and Surgery, Community-Based Practice
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
Schlesinger M, Kanouse DE, Martino SC
Complexity, public reporting, and choice of doctors: a look inside the blackest box of consumer behavior.
The authors identified four pathways through which complexity may impair consumer choice. They examined these pathways using data from an experiment in which consumers hypothetically selected a primary care physician. They found that some of the loss of decision quality accompanying more complex choice sets can be explained by consumers' skills and decision-making style, but even after accounting for these factors, complexity undermines the quality of decision making in ways that cannot be fully explained. They concluded by discussing implications for report designers, sponsors, and policy makers aspiring to promote consumer empowerment and health care quality.
AHRQ-funded; HS016978; HS016980.
Citation: Schlesinger M, Kanouse DE, Martino SC .
Complexity, public reporting, and choice of doctors: a look inside the blackest box of consumer behavior.
Med Care Res Rev 2014 Oct;71(5 Suppl):38s-64s. doi: 10.1177/1077558713496321.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Decision Making, Quality of Care, Primary Care, Public Reporting
Shaller D, Kanouse DE, Schlesinger M
Context-based strategies for engaging consumers with public reports about health care providers.
The authors identified three key factors influencing consumer engagement and showed how they manifest in different ways and combinations for four particular choice contexts that appear to offer realistic opportunities for engagement. They also analyzed how these engagement factors play out differently in each choice context and suggest specific strategies that sponsors of public reports can use in each context.
AHRQ-funded; HS016978; HS016980.
Citation: Shaller D, Kanouse DE, Schlesinger M .
Context-based strategies for engaging consumers with public reports about health care providers.
Med Care Res Rev 2014 Oct;71(5 Suppl):17s-37s. doi: 10.1177/1077558713493118.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Patient and Family Engagement, Public Reporting
Anhang Price R, Elliott MN, Zaslavsky AM
Examining the role of patient experience surveys in measuring health care quality.
The authors reviewed the literature on the association between patient experiences and other measures of health care quality. They concluded that patient experience measures that are collected using psychometrically sound instruments, employing recommended sample sizes and adjustment procedures, and implemented according to standard protocols are intrinsically meaningful and are appropriate complements for clinical process and outcome measures in public reporting and pay-for-performance programs.
AHRQ-funded; HS016980; HS016978.
Citation: Anhang Price R, Elliott MN, Zaslavsky AM .
Examining the role of patient experience surveys in measuring health care quality.
Med Care Res Rev 2014 Oct;71(5):522-54. doi: 10.1177/1077558714541480.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Quality of Care, Quality Improvement, Quality Measures
Hays RD, Berman LJ, Kanter MH
Evaluating the psychometric properties of the CAHPS Patient-Centered Medical Home survey.
This study surveyed Medicare beneficiaries to evaluate the reliability and validity of a new five-item care coordination measure. The composite score had a strong unique association with the CAHPS global rating of health care, after controlling for the CAHPS core composite scores.
AHRQ-funded; HS016980
Citation: Hays RD, Berman LJ, Kanter MH .
Evaluating the psychometric properties of the CAHPS Patient-Centered Medical Home survey.
Clin Ther. 2014 May;36(5):689-696.e1. doi: 10.1016/j.clinthera.2014.04.004..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Medicare, Patient Experience, Patient-Centered Healthcare