Beverly A Weidmer1, Paul D Cleary2, San Keller3, Christian Evensen3, Margarita P Hurtado4, Beth Kosiak5, Patricia M Gallagher6, Roger Levine7, Ron D Hays8. 1. RAND Corporation, Santa Monica, CA. Electronic address: beverly_weidmer@rand.org. 2. Yale School of Public Health, New Haven, CT. 3. American Institutes for Research, Chapel Hill, NC. 4. American Institutes for Research, Silver Spring, MA. 5. Agency for Healthcare Research and Quality, Rockville, MD. 6. University of Massachusetts, Boston, MA. 7. American Institutes for Research, San Mateo. 8. UCLA Department of Medicine, Los Angeles, CA.
Abstract
BACKGROUND: The US Centers for Medicare & Medicaid Services assess patient experiences of care as part of the end-stage renal disease prospective payment system and Quality Incentive Program. This article describes the development and evaluation of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) In-Center Hemodialysis Survey. STUDY DESIGN: We conducted formative research to generate survey questions and performed statistical analyses to evaluate the survey's measurement properties. SETTING & PARTICIPANTS: Formative research included focus groups, cognitive interviews, and field testing the survey with dialysis patients. MEASUREMENTS & OUTCOMES: We assessed internal consistency reliability (Cronbach alpha) and center-level reliability for 3 multi-item scales. We evaluated construct validity using correlations of the scales with global ratings of the kidney doctor, staff, and dialysis center. RESULTS: Response rate was 46% (1,454 completed surveys). Analyses support 3 multi-item scales: Nephrologists' Communication and Caring (7 items, alpha=0.89), Quality of Dialysis Center Care and Operations (22 items, alpha=0.93), and Providing Information to Patients (11 items, alpha=0.75). The communication scale was correlated the most strongly with the global rating of the "kidney doctor" (r=0.78). The Dialysis Center Care and Operations scale was correlated most strongly with global ratings of staff (r=0.75) and the center (r=0.69). Providing Information to Patients was correlated most strongly with the global rating of the staff (r=0.41). LIMITATIONS: A relatively small number of patients completed the survey in Spanish. CONCLUSIONS: This study provides support for the reliability and validity of the CAHPS In-Center Hemodialysis Survey for assessing patient experiences of care at dialysis facilities. The survey can be used to compare care provided at different facilities.
BACKGROUND: The US Centers for Medicare & Medicaid Services assess patient experiences of care as part of the end-stage renal disease prospective payment system and Quality Incentive Program. This article describes the development and evaluation of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) In-Center Hemodialysis Survey. STUDY DESIGN: We conducted formative research to generate survey questions and performed statistical analyses to evaluate the survey's measurement properties. SETTING & PARTICIPANTS: Formative research included focus groups, cognitive interviews, and field testing the survey with dialysis patients. MEASUREMENTS & OUTCOMES: We assessed internal consistency reliability (Cronbach alpha) and center-level reliability for 3 multi-item scales. We evaluated construct validity using correlations of the scales with global ratings of the kidney doctor, staff, and dialysis center. RESULTS: Response rate was 46% (1,454 completed surveys). Analyses support 3 multi-item scales: Nephrologists' Communication and Caring (7 items, alpha=0.89), Quality of Dialysis Center Care and Operations (22 items, alpha=0.93), and Providing Information to Patients (11 items, alpha=0.75). The communication scale was correlated the most strongly with the global rating of the "kidney doctor" (r=0.78). The Dialysis Center Care and Operations scale was correlated most strongly with global ratings of staff (r=0.75) and the center (r=0.69). Providing Information to Patients was correlated most strongly with the global rating of the staff (r=0.41). LIMITATIONS: A relatively small number of patients completed the survey in Spanish. CONCLUSIONS: This study provides support for the reliability and validity of the CAHPS In-Center Hemodialysis Survey for assessing patient experiences of care at dialysis facilities. The survey can be used to compare care provided at different facilities.
Authors: Robert Wood; Carly J Paoli; Ron D Hays; Gavin Taylor-Stokes; James Piercy; Matthew Gitlin Journal: Clin J Am Soc Nephrol Date: 2014-05-15 Impact factor: 8.237
Authors: Mark J Sarnak; Andrew S Levey; Anton C Schoolwerth; Josef Coresh; Bruce Culleton; L Lee Hamm; Peter A McCullough; Bertram L Kasiske; Ellie Kelepouris; Michael J Klag; Patrick Parfrey; Marc Pfeffer; Leopoldo Raij; David J Spinosa; Peter W Wilson Journal: Circulation Date: 2003-10-28 Impact factor: 29.690
Authors: R W Evans; D L Manninen; L P Garrison; L G Hart; C R Blagg; R A Gutman; A R Hull; E G Lowrie Journal: N Engl J Med Date: 1985-02-28 Impact factor: 91.245
Authors: Steven D Weisbord; Sharon S Carmody; Frank J Bruns; Armando J Rotondi; Lewis M Cohen; Mark L Zeidel; Robert M Arnold Journal: Nephrol Dial Transplant Date: 2003-07 Impact factor: 5.992
Authors: Rebecca Anhang Price; Marc N Elliott; Alan M Zaslavsky; Ron D Hays; William G Lehrman; Lise Rybowski; Susan Edgman-Levitan; Paul D Cleary Journal: Med Care Res Rev Date: 2014-07-15 Impact factor: 3.929
Authors: Michelle M Richardson; Susan S Paine; Megan E Grobert; Christine A Stidley; Ezra Gabbay; Antonia M Harford; Philip G Zager; Dana C Miskulin; Klemens B Meyer Journal: Clin J Am Soc Nephrol Date: 2015-06-30 Impact factor: 8.237
Authors: Brian M Brady; Bo Zhao; Jingbo Niu; Wolfgang C Winkelmayer; Arnold Milstein; Glenn M Chertow; Kevin F Erickson Journal: JAMA Intern Med Date: 2018-10-01 Impact factor: 21.873