Examining the effect of item-level measurement bias on the measurement of racial and ethnic disparities in patients' experiences of ambulatory care

Patient-reported ambulatory care experience measures that are valid and reliable are integral in efforts to bring about a patient-centered health care system. The existence of differential item functioning (DIF) by race/ethnicity, education, or primary language in comparisons and estimations of physician or medical group performance could lead to bias in measurement. Examining the impact of sources of DIF on measures of ambulatory care experience and comparisons of relative performance of individual physicians or medical groups could provide useful information. This study will: (1) review the impact of sources of DIF on two years of Clinician & Group CAHPS measures; (2) attempt to ascertain how DIF influences comparisons of physician performance (overall, between-group, and within-group) on patient experience measures; and (3) investigate how sources of DIF influence relative physician ranking and compare those results to physician rankings using composite scores that do not address DIF.

Grant Details

Amount Awarded $75,000.00

Awarded on: 8/19/2009

Time frame: 9/1/2009 - 3/31/2012

Grant Number: 66626


University of California, Los Angeles, Fielding School of Public Health

16-035 CHS
Box 951772
Los Angeles, 90095-1772


Hector P. Rodriguez
Project Director