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Patient experience measures are now recognized as central to a comprehensive assessment of health care quality. Large-scale initiatives such as pay-for-performance and public reporting programs require reliable and valid information about physician-level performance from probability samples of adequate size (Safran et al. 2006; Rodriguez et al. 2009;). The Agency for Healthcare Research and Quality's Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician and Group survey (C/G CAHPS) has been approved by the National Quality Forum (NQF) as a measure of patient experiences with individual physicians and their practice sites (Agency for Healthcare Research and Quality, American Institutes for Research, Harvard Medical School, and RAND Corporation 2006). A major issue when using surveys for large assessments is the cost of survey administration. When compared with mail or phone administration of surveys, in-office distribution of survey instruments (“handout”) can reduce costs by relying on staff time and greatly limiting the costs associated with mail or telephone-based data collection (Schonlau, Fricker, and Elliott 2002; Gribble and Haupt 2005;). Modes that require interaction with an interviewer, such as face-to-face or telephone administration, have been shown to elicit more positive ratings of care than mail surveys (Walker and Restuccia 1984; de Vries et al. 2005;), and modes that reduce the elapsed time between the visit and survey completion have also been shown to produce more favorable assessments (Savage and Armstrong 1990; Kinnersley et al. 1996;). There is limited evidence on differences in response rates and response patterns between surveys that are distributed in an office and mailed surveys. One study found that handing out surveys resulted in higher response rates, more favorable ratings, less overall variation in patient response, and higher item-level nonresponse compared with surveys administered by mail (Gribble and Haupt 2005). However, more information is needed about whether and how survey distribution method affects response rates and the results obtained. We conducted a multisite randomized trial of handout and mail survey distribution to adult patients from the panels of 15 primary care physicians in a large multispecialty medical group in New York. We compared physician and site-level scores, response rates, the characteristics of respondents, and response patterns between surveys distributed using the different methods. |
