Development of items to assess patients' health literacy experiences at hospitals for the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospital Survey

Med Care. 2012 Sep;50(9 Suppl 2):S12-21. doi: 10.1097/MLR.0b013e31826524a0.

Abstract

Background: The complexity of health information frequently exceeds patients' skills to understand and use it. Improvement in hospital communication has the potential to improve the quality of care.

Objective: To develop a set of items to supplement the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospital Survey (HCAHPS) to assess how well hospitals communicate health information to inpatients.

Methods: We conducted an environmental scan and obtained input from stakeholders to identify domains and survey items, and cognitively tested the item set in English and Spanish. We administered the items to a random sample of adult hospital patients using mail and telephone data collection. We estimate item-scale correlations for hypothesized multi-item composites, internal consistency reliability for composites, correlations among composites, and regressed global rating of the hospital and a would you recommend the hospital items on HCAHPS existing core and the new composites to evaluate the unique contribution of each to these "bottom-line" measures.

Results: A total of 1013 surveys were obtained (55% response rate). With some exceptions, correlations between items and scales were consistent with the hypothesized item clusters. Three composites were identified: (1) communication about tests; (2) communication about how to care for self and medicines; and (3) communication about forms.

Conclusions: This study provides support for the measurement properties of the HCAHPS Item Set for Addressing Health Literacy. It can serve as both a measure of whether healthcare providers in a hospital setting have communicated effectively with their patients and as a tool for quality improvement.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Communication*
  • Female
  • Health Care Surveys
  • Health Literacy*
  • Health Services Research / methods*
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Patient Education as Topic
  • Patient Satisfaction
  • Personnel, Hospital*
  • Professional-Patient Relations*
  • Quality of Health Care / organization & administration
  • Socioeconomic Factors
  • Translating
  • Young Adult