Overall scores as an alternative to global ratings in patient experience surveys: A comparison of four methods

M.W. Krol, D. de Boer, J.J.D.J.M. Rademakers, D. Delnoij

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Abstract

Background
Global ratings of healthcare by patients are a popular way of summarizing patients’ experiences. Summary scores can be used for comparing healthcare provider performance and provider rankings. As an alternative, overall scores from actual patient experiences can be constructed as summary scores. This paper addresses the statistical and practical characteristics of overall scores as an alternative to a global rating in summarizing patient survey results.
Methods
Data from a 2010 patient experience survey for approximately 12,000 nursing home residents (7.5% of all Dutch nursing home residents at the time) from 464 nursing homes in the Netherlands (25% of the Dutch nursing homes) was used. Data was collected through specifically designed standardized interview surveys. The respondents’ scores for 15 established quality indicators (or composites) for nursing home care were used to calculate overall scores for each nursing home, using four different strategies. The characteristics of the overall scores were compared against each other and with the respondents’ global rating.
Results
The individual indicators showed stronger associations with each of the four overall strategies than with the global ratings. Furthermore, the dispersion of the overall scores across nursing homes was greater. Differences between overall scores appeared limited.
Conclusions
Overall scores proved more valid than global ratings as a summary of the indicator scores, and also showed more pronounced differences between nursing homes. Because of the limited statistical differences between the strategies, and for practical reasons, a straightforward averaging of quality indicator scores may be preferred as an overall score.
Keywords: Quality of care, Composite measures, Nursing home, Consumer information
Original languageEnglish
Article number479
JournalBMC Health Services Research
Volume13
DOIs
Publication statusPublished - 2013

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Surveys and Questionnaires
Home Care Services
Health Personnel
Netherlands
Interviews
Delivery of Health Care

Cite this

@article{d47c853af42d4be88f49175e6734c1fd,
title = "Overall scores as an alternative to global ratings in patient experience surveys: A comparison of four methods",
abstract = "BackgroundGlobal ratings of healthcare by patients are a popular way of summarizing patients’ experiences. Summary scores can be used for comparing healthcare provider performance and provider rankings. As an alternative, overall scores from actual patient experiences can be constructed as summary scores. This paper addresses the statistical and practical characteristics of overall scores as an alternative to a global rating in summarizing patient survey results.MethodsData from a 2010 patient experience survey for approximately 12,000 nursing home residents (7.5{\%} of all Dutch nursing home residents at the time) from 464 nursing homes in the Netherlands (25{\%} of the Dutch nursing homes) was used. Data was collected through specifically designed standardized interview surveys. The respondents’ scores for 15 established quality indicators (or composites) for nursing home care were used to calculate overall scores for each nursing home, using four different strategies. The characteristics of the overall scores were compared against each other and with the respondents’ global rating.ResultsThe individual indicators showed stronger associations with each of the four overall strategies than with the global ratings. Furthermore, the dispersion of the overall scores across nursing homes was greater. Differences between overall scores appeared limited.ConclusionsOverall scores proved more valid than global ratings as a summary of the indicator scores, and also showed more pronounced differences between nursing homes. Because of the limited statistical differences between the strategies, and for practical reasons, a straightforward averaging of quality indicator scores may be preferred as an overall score.Keywords: Quality of care, Composite measures, Nursing home, Consumer information",
author = "M.W. Krol and {de Boer}, D. and J.J.D.J.M. Rademakers and D. Delnoij",
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doi = "10.1186/1472-6963-13-479",
language = "English",
volume = "13",
journal = "BMC Health Services Research",
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Overall scores as an alternative to global ratings in patient experience surveys : A comparison of four methods. / Krol, M.W.; de Boer, D.; Rademakers, J.J.D.J.M.; Delnoij, D.

In: BMC Health Services Research, Vol. 13, 479, 2013.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Overall scores as an alternative to global ratings in patient experience surveys

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AU - de Boer, D.

AU - Rademakers, J.J.D.J.M.

AU - Delnoij, D.

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N2 - BackgroundGlobal ratings of healthcare by patients are a popular way of summarizing patients’ experiences. Summary scores can be used for comparing healthcare provider performance and provider rankings. As an alternative, overall scores from actual patient experiences can be constructed as summary scores. This paper addresses the statistical and practical characteristics of overall scores as an alternative to a global rating in summarizing patient survey results.MethodsData from a 2010 patient experience survey for approximately 12,000 nursing home residents (7.5% of all Dutch nursing home residents at the time) from 464 nursing homes in the Netherlands (25% of the Dutch nursing homes) was used. Data was collected through specifically designed standardized interview surveys. The respondents’ scores for 15 established quality indicators (or composites) for nursing home care were used to calculate overall scores for each nursing home, using four different strategies. The characteristics of the overall scores were compared against each other and with the respondents’ global rating.ResultsThe individual indicators showed stronger associations with each of the four overall strategies than with the global ratings. Furthermore, the dispersion of the overall scores across nursing homes was greater. Differences between overall scores appeared limited.ConclusionsOverall scores proved more valid than global ratings as a summary of the indicator scores, and also showed more pronounced differences between nursing homes. Because of the limited statistical differences between the strategies, and for practical reasons, a straightforward averaging of quality indicator scores may be preferred as an overall score.Keywords: Quality of care, Composite measures, Nursing home, Consumer information

AB - BackgroundGlobal ratings of healthcare by patients are a popular way of summarizing patients’ experiences. Summary scores can be used for comparing healthcare provider performance and provider rankings. As an alternative, overall scores from actual patient experiences can be constructed as summary scores. This paper addresses the statistical and practical characteristics of overall scores as an alternative to a global rating in summarizing patient survey results.MethodsData from a 2010 patient experience survey for approximately 12,000 nursing home residents (7.5% of all Dutch nursing home residents at the time) from 464 nursing homes in the Netherlands (25% of the Dutch nursing homes) was used. Data was collected through specifically designed standardized interview surveys. The respondents’ scores for 15 established quality indicators (or composites) for nursing home care were used to calculate overall scores for each nursing home, using four different strategies. The characteristics of the overall scores were compared against each other and with the respondents’ global rating.ResultsThe individual indicators showed stronger associations with each of the four overall strategies than with the global ratings. Furthermore, the dispersion of the overall scores across nursing homes was greater. Differences between overall scores appeared limited.ConclusionsOverall scores proved more valid than global ratings as a summary of the indicator scores, and also showed more pronounced differences between nursing homes. Because of the limited statistical differences between the strategies, and for practical reasons, a straightforward averaging of quality indicator scores may be preferred as an overall score.Keywords: Quality of care, Composite measures, Nursing home, Consumer information

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