Development of items to assess patients' health literacy experiences at hospitals for the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospital Survey.
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.
RAND Corporation, Santa Monica, CA 90407-2138, USA. beverly_weidmer@rand.org
Beverly A
BA
Weidmer
Cindy
C
Brach
Mary E
ME
Slaughter
Ron D
RD
Hays
D000293:Adolescent; D000328:Adult; D000368:Aged; D003142:Communication; D005260:Female; D019538:Health Care Surveys; D057220:Health Literacy; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D010564:Personnel, Hospital; D011369:Professional-Patient Relations; D011787:Quality of Health Care / Q000458:organization & administration; D012959:Socioeconomic Factors; D014175:Translating; D055815:Young Adult