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Possibilities for Shortening the CAHPS Clinician and Group Survey

Stucky, Brian D., PhD*; Hays, Ron D., PhD*,†; Edelen, Maria O., PhD*; Gurvey, Jill, MPH*; Brown, Julie A., BA*

doi: 10.1097/MLR.0000000000000452
Brief Report

Background: The Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician and Group adult survey (CG-CAHPS) includes 34 items used to monitor the quality of ambulatory care from the patient’s perspective. CG-CAHPS includes items assessing access to care, provider communication, and courtesy and respect of office staff. Stakeholders have expressed concerns about the length of the CG-CAHPS survey.

Objectives: This paper explores the impact on reliability and validity of the CAHPS domain scores of reducing the numbers of items used to assess the 3 core CG-CAHPS domains (Provider Communication, Access to Care, and Courteous and Helpful Office Staff).

Research Design: CG-CAHPS data reported here consist of 136,725 patients across 4 datasets including ambulatory clinics, patient-centered medical homes, and Accountable Care Organizations. Analyses are conducted in parallel across the 4 settings to allow evaluations across data source.

Analyses: Multiple regression and ANOVA techniques were used to evaluate reliability for shorter sets of items. Site-level correlations with the overall rating of the provider were compared to evaluate the impact on validity. The change in practices’ rank-ordering as a function of domain revision is also reported.

Results: Findings suggest that the Provider Communication (6 items) and Access (5 items) domains can be reduced to as few as 2 items each and Office Staff (2 items) can be reduced to a single item without a substantial loss in reliability or content.

Conclusions: The performance of several of the reduced-length options for CG-CAHPS domains closely matches the full versions and may be useful in health care settings where the full-length survey is impractical due to time or cost constraints.

*RAND Corporation, Santa Monica

Department of Medicine, UCLA, Los Angeles, CA

Supported by the Agency for Healthcare Research and Quality’s Award Number 2U18HS016980.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality.

The authors declare no conflict of interest.

Reprints: Brian D. Stucky, PhD, RAND Corporation, 1776 Main Street, Santa Monica, CA 90407-2138. E-mail:

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