TY - JOUR
T1 - Development of valid and reliable measures of patient and family experiences of hospice care for public reporting
AU - Price, Rebecca Anhang
AU - Stucky, Brian
AU - Parast, Layla
AU - Elliott, Marc N.
AU - Haas, Ann
AU - Bradley, Melissa
AU - Teno, Joan M.
N1 - Funding Information:
The data collection on which this publication is based was sponsored by CMS under contract numbers HHSM-500-2014-00350G and HHSM-500-2016-00022G, entitled, ‘‘National Implementation of the Hospice Experience of Care Survey’’ and ‘‘National Implementation of the CAHPS Hospice Survey,’’ funded by the Centers for Medicare & Medicaid Services, Department of Health and Human Services. The content of this publication neither necessarily reflect the views or policies of the Department of Health and Human Services nor does the mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. The authors assume full responsibility for the accuracy and completeness of the ideas presented.
Publisher Copyright:
© Mary Ann Liebert, Inc. 2018.
PY - 2018/7
Y1 - 2018/7
N2 - Background: Increasingly, dying patients and their families have a choice of hospice providers. Care quality varies considerably across providers; informing consumers of these differences may help to improve their selection of hospices. Objective: To develop and evaluate standardized survey measures of hospice care experiences for the purpose of comparing and publicly reporting hospice performance. Design: We assessed item performance and constructed composite measures by factor analysis, evaluating item-scale correlations and estimating reliability. To assess key drivers of overall experiences, we regressed overall rating and willingness to recommend the hospice on each composite. Setting/Subjects: Data submitted by 2500 hospices participating in national implementation of the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Hospice Survey for April through September 2015. Measurements: Composite measures of Hospice Team Communication, Getting Timely Care, Treating Family Member with Respect, Getting Emotional and Religious Support, Getting Help for Symptoms, and Getting Hospice Care Training. Results: Cronbach's alpha estimates for the composite measures range from 0.61 to 0.85; hospice-level reliability for the measures range from 0.67 to 0.81 assuming 200 completed surveys per hospice. Together, the composites are responsible for 48% of the variance in caregivers' overall ratings of hospices. Hospice Team Communication is the strongest predictor of overall rating of care. Conclusion: Our analyses provide evidence of the reliability and validity of CAHPS Hospice Survey measure scores. Results also highlight important opportunities to improve the quality of hospice care, particularly with regard to addressing symptoms of anxiety and sadness, discussing side effects of pain medicine, and keeping family informed of the patient's condition.
AB - Background: Increasingly, dying patients and their families have a choice of hospice providers. Care quality varies considerably across providers; informing consumers of these differences may help to improve their selection of hospices. Objective: To develop and evaluate standardized survey measures of hospice care experiences for the purpose of comparing and publicly reporting hospice performance. Design: We assessed item performance and constructed composite measures by factor analysis, evaluating item-scale correlations and estimating reliability. To assess key drivers of overall experiences, we regressed overall rating and willingness to recommend the hospice on each composite. Setting/Subjects: Data submitted by 2500 hospices participating in national implementation of the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Hospice Survey for April through September 2015. Measurements: Composite measures of Hospice Team Communication, Getting Timely Care, Treating Family Member with Respect, Getting Emotional and Religious Support, Getting Help for Symptoms, and Getting Hospice Care Training. Results: Cronbach's alpha estimates for the composite measures range from 0.61 to 0.85; hospice-level reliability for the measures range from 0.67 to 0.81 assuming 200 completed surveys per hospice. Together, the composites are responsible for 48% of the variance in caregivers' overall ratings of hospices. Hospice Team Communication is the strongest predictor of overall rating of care. Conclusion: Our analyses provide evidence of the reliability and validity of CAHPS Hospice Survey measure scores. Results also highlight important opportunities to improve the quality of hospice care, particularly with regard to addressing symptoms of anxiety and sadness, discussing side effects of pain medicine, and keeping family informed of the patient's condition.
KW - CAHPS
KW - bereaved family survey
KW - hospice care
KW - patient and family care experiences
KW - quality measurement
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U2 - 10.1089/jpm.2017.0594
DO - 10.1089/jpm.2017.0594
M3 - Article
C2 - 29649404
AN - SCOPUS:85049588700
SN - 1096-6218
VL - 21
SP - 924
EP - 932
JO - Journal of palliative medicine
JF - Journal of palliative medicine
IS - 7
ER -