Do Medicaid and commercial CAHPS scores correlate within plans?: a New Jersey case study.
Do Medicaid and commercial CAHPS scores correlate within plans?: a New Jersey case study.
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医疗补助和商业 CAHPS 分数在计划内是否相关？：新泽西州案例研究。
DOI：
10.1097/01.mlr.0000178200.72371.b7
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发表时间：
2005
期刊：
影响因子：
3
通讯作者：
Hays,RonD
中科院分区：
文献类型：
--
作者：
Elliott,MarcN;Farley,Donna;Hambarsoomians,Katrin;Hays,RonD
背景：消费者健康计划评估研究（CAHPS）健康计划调查目前对医疗补助受益人和管理式医疗机构的商业参保人进行了大量独立样本的管理。有兴趣减少调查管理成本和样本量要求通过抽样这两个组一起进行健康计划比较。计划经理也可能对了解计划中的可变性感兴趣。目的：本研究的目的是评估两个人群CAHPS评分的计划内相关性是否足够大，以保证相互推断，减少所需的总样本量。研究设计：本研究为观察性横断面研究。受试者：受试者为3939名医疗补助受益人和3027名商业参保者，他们分别来自6个新泽西管理式医疗计划，为这两个人群服务。测量方法：结果是来自CAHPS 1.0调查的4个全球评级和6个报告组合。结果：在6项综合指标中，医疗补助受益人报告的护理质量比商业受益人差，但在4项全球评分中均没有。在控制这些主要影响的情况下，在10项测量中，商业参保者和医疗补助受益人之间的变异性在4项测量中超过了商业参保者计划之间的变异性（2项综合评分，2项全球评分）。结论：在医疗补助和商业健康计划成员评估的护理评估中，计划内变异性太大，以至于无法对许多重要结果的一个人群的计划绩效进行有意义的推断；仍应进行单独的调查。
Background:The Consumer Assessment of Health Plans Study (CAHPS) health plan survey is currently administered to large independent samples of Medicaid beneficiaries and commercial enrollees for managed care organizations that serve both populations. There is interest in reducing survey administration costs and sample size requirements by sampling these 2 groups together for health plan comparisons. Plan managers may also be interested in understanding variability within plans.Objective:The objective of this study was to assess whether the within plan correlation of CAHPS scores for the 2 populations are sufficiently large to warrant inferences about one from the other, reducing the total sample sizes needed.Research Design:This study consisted of an observational cross-sectional study.Subjects:Subjects were 3939 Medicaid beneficiaries and 3027 commercial enrollees in 6 New Jersey managed care plans serving both populations.Measures:Outcomes are 4 global ratings and 6 report composites from the CAHPS 1.0 survey.Results:Medicaid beneficiaries reported poorer care than commercial beneficiaries for 6 composites, but none of the 4 global ratings. Controlling for these main effects, variability between commercial enrollees and Medicaid beneficiaries within plans exceeded variability by plans for commercial enrollees for 4 of the 10 measures (2 composites, 2 global ratings).Conclusions:Within-plan variability in evaluations of care by Medicaid and commercial health plan member evaluations is too great to permit meaningful inference about plan performance for one population from the other for many important outcomes; separate surveys should still be fielded.