National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Ambulatory Care and Surgery (1)
- Cancer (1)
- Care Coordination (2)
- Caregiving (1)
- Children/Adolescents (3)
- Clinician-Patient Communication (1)
- Community-Based Practice (1)
- (-) Consumer Assessment of Healthcare Providers and Systems (CAHPS) (21)
- Decision Making (1)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (3)
- Health Insurance (1)
- Health Literacy (1)
- Health Systems (1)
- Hospital Discharge (1)
- Hospitalization (1)
- Hospitals (6)
- Implementation (1)
- Inpatient Care (1)
- Kidney Disease and Health (1)
- Low-Income (1)
- Medicare (3)
- Nursing (1)
- Patient-Centered Healthcare (3)
- Patient and Family Engagement (2)
- Patient Experience (19)
- Primary Care (4)
- Primary Care: Models of Care (1)
- Provider Performance (3)
- Public Reporting (2)
- Quality Improvement (8)
- Quality Indicators (QIs) (1)
- Quality Measures (6)
- Quality of Care (20)
- Racial and Ethnic Minorities (2)
- Research Methodologies (1)
- Teams (1)
- Transitions of Care (1)
- Transplantation (1)
- Urban Health (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 21 of 21 Research Studies DisplayedQuigley DD, Qureshi N, Masarweh LA
Practice leaders report targeting several types of changes in care experienced by patients during patient-centered medical home transformation.
This study looked at how primary care practices implemented changes during the transition to becoming a patient-centered medical home (PCMH). The authors examined 105 primary care practice leader experiences during PCMH transformation using semi-structured interviews. Practices most commonly targeted changes in care coordination (30%), access to care (25%), and provider communication (24%). Reported areas for PCMH transformation were measured by Clinician & Group CAHPS, PCMH CAHPS, or supplemental CAHPS survey items, including team-based care (35%), providing more on-site services (28%), care management (22%), patient-centered culture (18%), and chronic condition health education (13%). Many PCMH changes are captured by CAHPS survey items, but some are not.
AHRQ-funded; HS025920.
Citation: Quigley DD, Qureshi N, Masarweh LA .
Practice leaders report targeting several types of changes in care experienced by patients during patient-centered medical home transformation.
J Patient Exp 2020 Dec;7(6):1509-18. doi: 10.1177/2374373520934231..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Primary Care: Models of Care, Primary Care, Patient-Centered Healthcare, Patient Experience, Care Coordination, Quality Improvement, Quality of Care, Implementation
Short MN, Ho V
Weighing the effects of vertical integration versus market concentration on hospital quality.
Provider organizations are increasing in complexity, as hospitals acquire physician practices and physician organizations grow in size. At the same time, hospitals are merging with each other to improve bargaining power with insurers. In this study, the investigators analyzed 29 quality measures reported to the Center for Medicare and Medicaid Services' Hospital Compare database for 2008 to 2015 to test whether vertical integration between hospitals and physicians or increases in hospital market concentration influenced patient outcomes.
AHRQ-funded; HS024727.
Citation: Short MN, Ho V .
Weighing the effects of vertical integration versus market concentration on hospital quality.
Med Care Res Rev 2020 Dec;77(6):538-48. doi: 10.1177/1077558719828938.
.
.
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Patient Experience, Hospitals, Medicare, Provider Performance, Health Systems
Feng JY, Toomey SL, Elliott MN
Factors associated with family experience in pediatric inpatient care.
Researchers assessed which aspects of pediatric inpatient experience have the strongest relationships with parents' willingness to recommend a hospital. Their cross-sectional study examined surveys completed by parents of children hospitalized at hospitals using the Child Hospital Consumer Assessment of Healthcare Providers and Systems Survey. They found that child comfort and nurse-parent communication showed the strongest relationships with willingness to recommend, followed by preparing to leave the hospital, doctor-parent communication, and keeping parents informed. They recommended improvement efforts focusing on creating an age-appropriate environment, improving the effectiveness of provider interactions, and engaging parents to share their values and concerns.
AHRQ-funded; HS020513; HS025299.
Citation: Feng JY, Toomey SL, Elliott MN .
Factors associated with family experience in pediatric inpatient care.
Pediatrics 2020 Mar;145(3): e20191264. doi: 10.1542/peds.2019-1264..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Children/Adolescents, Quality Measures, Quality of Care, Inpatient Care, Patient Experience, Hospitals, Hospitalization, Patient and Family Engagement, Clinician-Patient Communication
Nembhard IM, Buta E, Lee YSH
A quasi-experiment assessing the six-months effects of a nurse care coordination program on patient care experiences and clinician teamwork in community health centers.
The authors assessed effects of adding care coordination formally to nurses’ roles on care experiences of high-risk patients and clinician teamwork during the first 6 months of use. They conducted a quasi-experimental study in which changes in staff and patient experiences at six community health center practice locations that introduced the added-role approach for high-risk patients were compared to changes in six locations without the program in the same health system. They found that there were some positive effects of adding care coordination to nurses' role within 6 months of implementation, suggesting value in this improvement strategy. They concluded that addressing compatibility between coordination and other job demands is important when implementing this approach to coordination.
AHRQ-funded; HS016978.
Citation: Nembhard IM, Buta E, Lee YSH .
A quasi-experiment assessing the six-months effects of a nurse care coordination program on patient care experiences and clinician teamwork in community health centers.
BMC Health Serv Res 2020 Feb 24;20(1):137. doi: 10.1186/s12913-020-4986-0..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Care Coordination, Nursing, Patient Experience, Community-Based Practice, Patient-Centered Healthcare, Ambulatory Care and Surgery, Teams
Shen NT, Wu A, Farrell K
Patient perspectives of high-quality care on the liver transplant waiting list: a qualitative study.
The prevalence of advanced liver disease and listing for liver transplantation is increasing. Prior assessments of quality of care neither incorporate nor emphasize the patient perspective on quality of care, which may impact clinical outcomes. In this study the investigators aimed to identify patients' perceptions on what constitutes high quality of care, comparing the findings to existing frameworks and assessments to determine if a patient-derived tool assessing quality of care could facilitate efforts to improve health care.
AHRQ-funded; HS000066.
Citation: Shen NT, Wu A, Farrell K .
Patient perspectives of high-quality care on the liver transplant waiting list: a qualitative study.
Liver Transpl 2020 Feb;26(2):238-46. doi: 10.1002/lt.25645..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Transplantation, Quality of Care, Healthcare Delivery, Patient Experience
Desai AD, Zhou C, Simon TD
Validation of a parent-reported hospital-to-home transition experience measure.
This study examined the validity of the Pediatric Transition Experience Measure (P-TEM), which is an 8-item, parent-reported measure that globally assesses hospital-to-home transition quality from discharge through follow-up compared to other validation measures. The other measures it was compared to included the 1) Child Hospital Consumer Assessment of Healthcare Providers and Systems Discharge Composite, 2) Center of Excellence on Quality of Care Measures for Children with Complex Needs parent-reported measures, 3) change in health-related quality of life from admission to postdischarge, and 4) 30-day emergency department revisits or readmissions. The P-TEM measure compared favorably with the Child Hospital Consumer Assessment of Healthcare Providers and Systems Discharge Composite measure and the other measures as well.
AHRQ-funded; HS024299.
Citation: Desai AD, Zhou C, Simon TD .
Validation of a parent-reported hospital-to-home transition experience measure.
Pediatrics 2020 Feb;145(2):pii: e20192150. doi: 10.1542/peds.2019-2150..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Children/Adolescents, Patient Experience, Transitions of Care, Hospital Discharge, Quality Improvement, Quality of Care, Quality Measures
Evensen CT, Yost KJ, Keller S
Development and testing of the CAHPS Cancer Care Survey.
In order to develop the CAHPS Cancer Care Survey instrument, the authors conducted cognitive tests of the instrument as well as field tests at six cancer centers and four community oncology practices; the survey was then finalized and obtained the CAHPS trademark. The authors recommend mail-only, mail-telephone mixed-mode, and Web-mail mixed-mode data collection methods.
AHRQ-funded; 290200600019I.
Citation: Evensen CT, Yost KJ, Keller S .
Development and testing of the CAHPS Cancer Care Survey.
J Oncol Pract 2019 Nov;15(11):e969-e78. doi: 10.1200/jop.19.00039..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Cancer, Patient Experience, Quality of Care
Hargraves JL, Cosenza C, Elliott MN, et al.
The effect of different sampling and recall periods in the CAHPS Clinician & Group (CG-CAHPS) survey.
Researchers examined the effect of changing the sampling and reference periods for the CAHPS((R)) Clinician & Group Survey from 12 to 6 months. They found that shortening the reference reduced the proportion of respondents reporting a blood test, X-ray, or other tests, and the most positive response was selected more often on the 6-month survey for 12 out of 13 questions. They concluded that surveys using a 6-month recall period may yield slightly higher scores than surveys with a 12-month recall period.
AHRQ-funded; HS016978.
Citation: Hargraves JL, Cosenza C, Elliott MN, et al..
The effect of different sampling and recall periods in the CAHPS Clinician & Group (CG-CAHPS) survey.
Health Serv Res 2019 Oct;54(5):1036-44. doi: 10.1111/1475-6773.13173..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Quality of Care, Research Methodologies
Beckett MK, Elliott MN, Burkhart Q
The effects of survey version on patient experience scores and plan rankings.
Researchers assessed the effect of changing survey questions on plan-level patient experience measures and ratings. Using CAHPS data, they concluded that their analyses illustrated how to assess the impact of seemingly minor survey modifications for other national surveys considering changes and highlighted the importance of screeners in instrument design.
AHRQ-funded; HS016978.
Citation: Beckett MK, Elliott MN, Burkhart Q .
The effects of survey version on patient experience scores and plan rankings.
Health Serv Res 2019 Oct;54(5):1016-22. doi: 10.1111/1475-6773.13172..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Medicare, Quality of Care
Setodji CM, Peipert JD, Hays RD
Differential item functioning of the CAHPS(R) In-Center Hemodialysis Survey.
End-stage renal disease patients' experience of care is an integral part of the assessment of the quality of the care provided at hemodialysis centers and is needed to promote patient choice, quality improvement, and accountability. The purpose of this study was to evaluate the In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH-CAHPS(R)) survey and its equivalence in different age, gender, race, and education subgroups.
AHRQ-funded; HS016980; HS016978.
Citation: Setodji CM, Peipert JD, Hays RD .
Differential item functioning of the CAHPS(R) In-Center Hemodialysis Survey.
Qual Life Res 2019 Jul 26;28(11):3117-35. doi: 10.1007/s11136-019-02250-5.
.
.
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Kidney Disease and Health, Quality of Care, Patient Experience, Quality Improvement
Ahluwalia SC, Damberg CL, Haas A
How are medical groups identified as high-performing? The effect of different approaches to classification of performance.
The researchers examined how different classification approaches influence which providers are designated as "high-performers.” They found that classification of medical groups as high performing is sensitive to the domains of performance included, the classification approach, and the choice of threshold. They further suggest that the absence of a consistently applied approach to identifying high performers impedes efforts to reliably compare, select and reward high-performing providers.
AHRQ-funded; HS024067.
Citation: Ahluwalia SC, Damberg CL, Haas A .
How are medical groups identified as high-performing? The effect of different approaches to classification of performance.
BMC Health Serv Res 2019 Jul 18;19(1):500. doi: 10.1186/s12913-019-4293-9..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Provider Performance, Quality of Care, Quality Measures
Sheetz KH, Nathan H, Dimick JB
Patients' perceptions of hospitals affiliated with America's highest-rated medical centers.
Using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to measure how patients perceive a hospital’s overall quality and reputation, the investigators sought to determine whether HCAHPS scores increased for those affiliating with the prominent medical centers named to the U.S. News and World Report Honor Roll.
AHRQ-funded; HS023597.
Citation: Sheetz KH, Nathan H, Dimick JB .
Patients' perceptions of hospitals affiliated with America's highest-rated medical centers.
J Gen Intern Med 2019 Jun;34(6):787-88. doi: 10.1007/s11606-018-4822-y..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Hospitals, Quality Measures, Quality of Care
Tieu L, Hobbs A, Sarkar U
Adapting patient experience data collection processes for lower literacy patient populations using tablets at the point of care.
This study compared the acceptability of low-literacy tablet-based and traditional paper-based patient experience surveys in English and Spanish. The Consumer Assessment of Healthcare Providers & Systems Clinician & Group Survey (CG-CAHPS) was adapted for a pilot survey using low-literacy questions in Spanish and English. The majority of interview participants preferred the tablet version over the traditional paper-based survey. This was especially true for the younger and Latino respondents.
AHRQ-funded; HS022408.
Citation: Tieu L, Hobbs A, Sarkar U .
Adapting patient experience data collection processes for lower literacy patient populations using tablets at the point of care.
Med Care 2019 Jun;57 Suppl 6 Suppl 2:S140-s48. doi: 10.1097/mlr.0000000000001030..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Health Information Technology (HIT), Health Literacy, Patient Experience, Primary Care, Quality of Care, Quality Improvement, Racial and Ethnic Minorities, Urban Health
Fowler FJ, Cosenza C, Cripps LA
The effect of administration mode on CAHPS survey response rates and results: a comparison of mail and web-based approaches.
The researchers compared response rates, respondents' characteristics, and substantive results for CAHPS surveys administered using web and mail protocols. They found that response rates to surveys administered using the Internet protocols were lower than for the surveys administered by mail, but characteristics of respondents and survey answers were very similar across protocols. Respondents without email addresses tended to be older, less educated, and more likely to be male than those with email addresses, and there were a few differences in their responses.
AHRQ-funded; HS016978.
Citation: Fowler FJ, Cosenza C, Cripps LA .
The effect of administration mode on CAHPS survey response rates and results: a comparison of mail and web-based approaches.
Health Serv Res 2019 Jun;54(3):714-21. doi: 10.1111/1475-6773.13109..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Health Information Technology (HIT), Patient Experience, Primary Care, Quality of Care, Quality Improvement
Hanson C, Herring B, Trish E
Do health insurance and hospital market concentration influence hospital patients' experience of care?
Researchers examined the effects of insurance and hospital market concentration on hospital patients' experience of care. They found that changes in patient satisfaction are positively associated with increases in insurance concentration and negatively associated with increases in hospital concentration. They concluded that their findings add to the evidence on the harms of hospital consolidation but suggest that insurer consolidation may improve patient experience.
AHRQ-funded; HS026333.
Citation: Hanson C, Herring B, Trish E .
Do health insurance and hospital market concentration influence hospital patients' experience of care?
Health Serv Res 2019 May 16;54(4):805-15. doi: 10.1111/1475-6773.13168..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Health Insurance, Hospitals, Patient Experience, Quality of Care, Quality Improvement
Toomey SL, Elliott MN, Zaslavsky AM
Improving response rates and representation of hard-to-reach groups in family experience surveys.
This study examined the use of an audio-enabled tablet to survey parents of children discharged from 4 units of a children’s hospital. Normal mail survey response rates are very low, especially for black, Latino, and low-income respondents. This survey was done day of discharge at the hospital and there was a response rate of 71.1% via tablet versus 16.3% for mail only. The Child Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey was used. Tablet response rates were highest with fathers, those more likely to have a high school education or less, less likely to be white, and more likely to be publicly insured. The results are promising for future surveys using tablet administration.
AHRQ-funded; HS020513; HS025299.
Citation: Toomey SL, Elliott MN, Zaslavsky AM .
Improving response rates and representation of hard-to-reach groups in family experience surveys.
Acad Pediatr 2019 May - Jun;19(4):446-53. doi: 10.1016/j.acap.2018.07.007..
Keywords: Caregiving, Children/Adolescents, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Health Information Technology (HIT), Hospitals, Low-Income, Patient Experience, Quality of Care, Quality Improvement, Racial and Ethnic Minorities
Cefalu MS, Elliott MN, Setodji CM
Hospital quality indicators are not unidimensional: a reanalysis of Lieberthal and Comer.
The objective of this study was to evaluate the dimensionality of hospital quality indicators treated as unidimensional in a prior publication. The investigators found that there were four underlying dimensions of hospital quality: patient experience, mortality, and two clinical process dimensions. They concluded that hospital quality should be measured using a variety of indicators reflecting different dimensions of quality.
AHRQ-funded; HS016980; HS016978.
Citation: Cefalu MS, Elliott MN, Setodji CM .
Hospital quality indicators are not unidimensional: a reanalysis of Lieberthal and Comer.
Health Serv Res 2019 Apr;54(2):502-08. doi: 10.1111/1475-6773.13056..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Patient Experience, Provider Performance, Quality of Care, Quality Indicators (QIs), Quality Measures
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.
.
.
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.
.
.
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.
.
.
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