This project seeks to advance answers to questions about the patient and patient-physician dyad characteristics associated with evaluations of experience with care, and the degree to which differences in survey responses among three ethnic groups represent differences in experience of care rather than differences in survey-taking specific to the instrument. The project specifically seeks to: (1) obtain and describe the responses of Hispanic, African-American, and Caucasian patients with a common pool of health care providers to the CAHPS Clinician & Group Adult Primary Care Survey (CAG); and (2) obtain and describe the responses of Hispanic, African-American, and Caucasian patients with a common pool of health care providers to the Clinical Value Congruence (CVC) scale, which measures the degree of fit between a patient and his/her provider on six dimensions of care values which are likely to vary both by culture and across individuals within the same culture and are unlikely to be associated with CAG composite scores. Nine hundred patients (300 African-American, 300 Hispanic, 300 Caucasian) and their physicians will be recruited from Family Medicine clinics staffed by a common set of providers. Patients will respond to the CAG, CVC, and health status instruments. It is hypothesized that to the degree that CAG responses reflect construct-irrelevant ethnic differences in survey-taking rather than differences in experienced health care, CAG scores will be more strongly predicted by ethnicity than by patient health status or individual patient value fit with their physician. These predictions will be tested through regression models. It is expected that this project will provide important information about the use of experience of care survey measures by ethnically diverse populations, under conditions that enable grantee to control for practice-level factors and investigate the impact of the patient-physician dyad on responses. Specific project deliverables include: (1) Spanish versions of the Clinical Value Congruence scales; (2) a data set consisting of individual-level responses to CAHPS Clinician & Group Survey items, Clinical Values Concordance items, and health status measures; and (3) comparison of responses illustrating similarities and differences among ethnic groups in global and composite ratings of clinician and group, in patient-physician value fit, and in the relationships between the constructs. These deliverables can inform survey designers who seek to ensure that survey responses correctly represent the experience of care across ethnic groups in order to improve health care access and equity.
Amount Awarded $98,847.00
Awarded on: 1/25/2008
Time frame: 2/15/2008 - 2/14/2010
Grant Number: 63821
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