title: Made in the USA: the import of American Consumer Assessment of Health Plan Surveys (CAHPS) into the Dutch social insurance system.
abstract: BACKGROUND
  In the Netherlands, managed competition between health plans has been introduced. For Dutch health plans this implies that they need to collect data about their own performance and that of the care providers they contract. To that end, Consumer Assessment of Health Plan Surveys (CAHPS) instruments have recently been adopted by a large Dutch health plan.
  
  
  OBJECTIVE
  This paper presents the results of a validation study of the Dutch version of the CAHPS Adult Commercial questionnaire. The questions addressed are as follows: Can this questionnaire be adapted for use in the context of the Dutch insurance system? and Can it generate valid information about the quality of health care and the performance of Dutch health plans?
  
  
  METHODS
  The translated questionnaire has been mailed to a sample of 977 enrollees. The psychometric properties of the translated instrument have been studied, and the results have been compared with those of other Dutch and American studies.
  
  
  RESULTS
  The net response rate was 51% (n = 500). In general, the questionnaires were filled out completely and consistently. Principal component analyses revealed a factor that can be labelled as patient-centredness in the primary process. It contains the domains that in the CAHPS literature are described as 'courteous/helpful staff' and 'doctors communicating well'.
  
  
  CONCLUSIONS
  The translated version of the CAHPS Adult Commercial questionnaire is a promising tool for Dutch health plans. More research is needed on the external and the content validity of these questionnaires in the Dutch context.
authors.affiliation: NIVEL (Netherlands institute for health services research), PO Box 1568, 3500 BN Utrecht, The Netherlands. d.delnoij@nivel.nl
authors.forename: Diana M J
authors.initials: DM
authors.lastname: Delnoij
authors.forename: Guus
authors.initials: G
authors.lastname: ten Asbroek
authors.forename: Onyebuchi A
authors.initials: OA
authors.lastname: Arah
authors.forename: Johan S
authors.initials: JS
authors.lastname: de Koning
authors.forename: Piet
authors.initials: P
authors.lastname: Stam
authors.forename: Aldien
authors.initials: A
authors.lastname: Poll
authors.forename: Barbara
authors.initials: B
authors.lastname: Vriens
authors.forename: Paul
authors.initials: P
authors.lastname: Schmidt
authors.forename: Niek S
authors.initials: NS
authors.lastname: Klazinga
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001294:Attitude to Health / Q000208:ethnology; D002755:Choice Behavior; D003142:Communication; D003466:Cultural Characteristics; D005163:Factor Analysis, Statistical; D019538:Health Care Surveys / Q000592:standards*; D006801:Humans; D007348:Insurance, Health / Q000592:standards*; D008875:Middle Aged; D009313:National Health Programs; D009426:Netherlands; D018802:Patient-Centered Care / Q000592:standards; D010865:Pilot Projects; D011369:Professional-Patient Relations; D011594:Psychometrics; D011787:Quality of Health Care / Q000592:standards*; D012943:Social Security; D011795:Surveys and Questionnaires / Q000592:standards*; D014175:Translating; D014481:United States