Center for Survey Research, University of Massachusetts Boston, 100 Morrissey Blvd., Boston, MA, 02125, USA.
Department of Sociology, University of Massachusetts Boston, 100 Morrissey Blvd., Boston, MA, 02125, USA.
BMC Health Serv Res. 2022 Jul 8;22(1):884. doi: 10.1186/s12913-022-08262-1.
The most widely used surveys for assessing patient health care experiences in the U.S. are the Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys. Studies examining the associations of language and ethnicity with responses to CAHPS surveys have yielded inconsistent findings. More research is needed to assess the effect of responding to CAHPS surveys in Spanish.
Subjects were patients who had received care at a study community health center in Connecticut within 6 or 12 months of being sent a CAHPS survey that asks about care experiences. The survey included four multi-item measures of care plus an overall rating of the provider. Sampled patients were mailed dual language (English and Spanish) cover letters and questionnaires. Those who did not respond after follow-up mailings were contacted by bilingual interviewers to complete the survey by telephone. We tested three hypotheses for any observed differences by ethnicity and language: 1. Spanish speakers are more likely than others to choose extreme response options. 2. The semantic meaning of the Spanish translation is not the same as the English version of the questions, resulting in Spanish speakers giving different answers because of meaning differences. 3. Spanish speakers have different expectations regarding their health care than those who answer in English. Analyses compared the answers on the survey measures for three groups: non-Hispanics answering in English, Hispanics answering in English, and Hispanics answering in Spanish.
The overall response rate was 45%. After adjusting for differences in demographic characteristics and self-rated health, those answering in Spanish gave significantly more positive reports than the other two groups on three of the five measures, and higher than the non-Hispanic respondents on a fourth.
Those answering in Spanish gave more positive reports of their medical experiences than Hispanics and non-Hispanics answering in English. Whether these results reflect different response tendencies, different standards for care, or better care experiences is a key issue in whether CAHPS responses in Spanish need adjustment to make them comparable to responses in English.
在美国，评估患者医疗保健体验最广泛使用的调查是医疗保健提供者和系统消费者评估（CAHPS）调查。研究检查语言和种族与 CAHPS 调查反应之间的关联产生了不一致的结果。需要更多的研究来评估用西班牙语回答 CAHPS 调查的效果。
研究对象是在康涅狄格州的一个社区卫生中心接受护理的患者，这些患者在收到 CAHPS 调查后的 6 或 12 个月内接受了调查，该调查询问了他们的护理体验。该调查包括四项护理多项指标和对提供者的整体评价。抽样患者收到了双语（英语和西班牙语）的封面信和问卷。在后续邮件发出后没有回复的患者会被双语采访者联系，通过电话完成调查。我们测试了三种假设，以确定任何观察到的种族和语言差异：1. 讲西班牙语的人比其他人更有可能选择极端的反应选项。2. 西班牙语翻译的语义与问题的英语版本不同，导致讲西班牙语的人因为意思的差异给出不同的答案。3. 讲西班牙语的人对医疗保健的期望与用英语回答的人不同。分析比较了三组调查措施的答案：用英语回答的非西班牙语者、用英语回答的西班牙语者和用西班牙语回答的西班牙语者。
总体回复率为 45%。在调整了人口统计学特征和自我评估健康状况的差异后，用西班牙语回答的人在五项措施中的三项上给出了明显更积极的报告，比其他两组都高，比非西班牙语回答者在第四项上也高。
用西班牙语回答的人对他们的医疗体验的评价比用英语回答的西班牙裔和非西班牙裔更积极。这些结果是反映了不同的反应倾向、不同的护理标准，还是更好的护理体验，这是 CAHPS 西班牙语回答是否需要调整以使它们与英语回答可比的关键问题。
