Do effects of common case-mix adjusters on patient experiences vary across patient groups?

Bibliographic Details
Title: Do effects of common case-mix adjusters on patient experiences vary across patient groups?
Authors: Dolf de Boer, Lucas van der Hoek, Jany Rademakers, Diana Delnoij, Michael van den Berg
Source: BMC Health Services Research, Vol 17, Iss 1, Pp 1-7 (2017)
Publisher Information: BMC, 2017.
Publication Year: 2017
Collection: LCC:Public aspects of medicine
Subject Terms: Patient experiences, Case-mix adjustment, Quality of care, Public aspects of medicine, RA1-1270
More Details: Abstract Background Many survey studies in health care adjust for demographic characteristics such as age, gender, educational attainment and general health when performing statistical analyses. Whether the effects of these demographic characteristics are consistent between patient groups remains to be determined. This is important as the rationale for adjustment is often that demographic sub-groups differ in their so-called ‘response tendency’. This rationale may be less convincing if the effects of response tendencies vary across patient groups. The present paper examines whether the impact of these characteristics on patients’ global rating of care varies across patient groups. Methods Secondary analyses using multi-level regression models were performed on a dataset including 32 different patient groups and 145,578 observations. For each demographic variable, the 95% expected range of case-mix coefficients across patient groups is presented. In addition, we report whether the variance of coefficients for demographic variables across patient groups is significant. Results Overall, men, elderly, lower educated people and people in good health tend to give higher global ratings. However, these effects varied significantly across patient groups and included the possibility of no effect or an opposite effect in some patient groups. Conclusion The response tendency attributed to demographic characteristics – such as older respondents being milder, or higher educated respondents being more critical – is not general or universal. As such, the mechanism linking demographic characteristics to survey results on patient experiences with quality of care is more complicated than a general response tendency. It is possible that the response tendency interacts with patient group, but it is also possible that other mechanisms are at play.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1472-6963
Relation: http://link.springer.com/article/10.1186/s12913-017-2732-z; https://doaj.org/toc/1472-6963
DOI: 10.1186/s12913-017-2732-z
Access URL: https://doaj.org/article/85e0e67e20704a5fb0570256182bb9b1
Accession Number: edsdoj.85e0e67e20704a5fb0570256182bb9b1
Database: Directory of Open Access Journals
More Details
ISSN:14726963
DOI:10.1186/s12913-017-2732-z
Published in:BMC Health Services Research
Language:English