Differences in Consumer Assessment of Healthcare Providers and Systems Clinician and Group Survey Scores by Recency of the Last Visit: Implications for Comparability of Periodic and Continuous Sampling

Med Care. 2019 Dec;57(12):e80-e86. doi: 10.1097/MLR.0000000000001134.

Abstract

Background: Patient experience data can be collected by sampling patients periodically (eg, patients with any visits over a 1-year period) or sampling visits continuously (eg, sampling any visit in a monthly interval). Continuous sampling likely yields a sample with more frequent and more recent visits, possibly affecting the comparability of data collected under the 2 approaches.

Objective: To explore differences in Consumer Assessment of Healthcare Providers and Systems Clinician and Group survey (CG-CAHPS) scores using periodic and continuous sampling.

Research design: We use observational data to estimate case-mix-adjusted differences in patient experience scores under 12-month periodic sampling and simulated continuous sampling.

Subjects: A total of 29,254 adult patients responding to the CG-CAHPS survey regarding visits in the past 12 months to any of 480 physicians, 2007-2009.

Measures: Overall doctor rating and 4 CG-CAHPS composite measures of patient experience: doctor communication, access to care, care coordination, and office staff.

Results: Compared with 12-month periodic sampling, simulated continuous sampling yielded patients with more recent visits (by definition), more frequent visits (92% of patients with 2+ visits, compared with 76%), and more positive case-mix-adjusted CAHPS scores (2-3 percentage points higher).

Conclusions: Patients with more frequent visits reported markedly higher CG-CAHPS scores, but this causes only small to moderate changes in adjusted physician-level scores between 12-month periodic and continuous sampling schemes. Caution should be exercised in trending or comparing scores collected through different schemes.

Publication types

  • Editorial
  • Observational Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Data Collection
  • Female
  • Health Care Surveys / methods*
  • Health Care Surveys / standards
  • Health Personnel / organization & administration*
  • Health Personnel / standards
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Patient Satisfaction*
  • Physician-Patient Relations
  • Reproducibility of Results
  • Young Adult