Psychometric properties of the Press Ganey® Outpatient Medical Practice Survey

Angela P Presson, Chong Zhang, Amir M Abtahi, Jacob Kean, Man Hung, Andrew R Tyser, Angela P Presson, Chong Zhang, Amir M Abtahi, Jacob Kean, Man Hung, Andrew R Tyser

Abstract

Background: The Press Ganey® Medical Practice Survey ("Press Ganey® survey") is a patient-reported questionnaire commonly used to measure patient satisfaction with outpatient health care in the United States. Our objective was to evaluate the reliability and validity of the Press Ganey® survey in a single institution setting.

Methods: We analyzed surveys from 34,503 unique respondents seen by 624 providers from 47 specialties and 94 clinics at the University of Utah in 2013. The University of Utah is a health care system that provides primary through tertiary care for over 200 medical specialties. Surveys were administered online. The Press Ganey® survey consisted of 24 items organized into 6 scales: Access (4 items), Moving Through the Visit (2), Nurse Assistant (2), Care Provider (10), Personal Issues (4) and Overall Assessment (2). Missingness, ceiling and floor rates were summarized. Cronbach's alpha was used to evaluate internal consistency reliability. Confirmatory factor analysis was used to assess convergent and discriminant validities.

Results: Missingness was 0.01% for the total score and ranged from 0.8 to 11.4% across items. The ceiling rate was high at 29.3% for the total score, and ranged from 55.4 to 84.1% across items. Floor rates were 0.01% for the total score, and ranged from 0.1 to 2.1% across items. Internal consistency reliability ranged from 0.79 to 0.96, and item-scale correlations ranged from 0.49 to 0.9. Confirmatory factor analysis supported convergent and discriminant validities.

Conclusion: The Press Ganey® survey demonstrated suitable psychometric properties for most metrics. However, the high ceiling rate can have a notable impact on quarterly percentile scores within our institution. Multi-institutional studies of the Press Ganey® survey are needed to inform administrative decision making and institution reimbursement decisions based on this survey.

Keywords: Confirmatory factor analysis; Consumer assessments; Patient satisfaction; Press Ganey® medical practice survey; Psychometrics.

Figures

Fig. 1
Fig. 1
Multi-dimensional scaling plot of the Press Ganey® survey questions colored by scale

References

    1. Centers for Medicare & Medicaid Services HCAHPS: Patients’ Perspectives of Care Survey []. Accessed 1 Mar 2015.
    1. Hospital Value-Based Purchasing []. Accessed 1 Mar 2015.
    1. H.R.3590 - Patient Protection and Affordable Care Act []. Accessed 16 June 2015.
    1. H.R.4015 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 []. Accessed 16 June 2015.
    1. Graham B, Green A, James M, Katz J, Swiontkowski M. Measuring patient satisfaction in orthopaedic surgery. J Bone Joint Surg Am. 2015;97(1):80–4. doi: 10.2106/JBJS.N.00811.
    1. Lee V, Miller T, Daniels C, Paine M, Gresh B, Betz AL. Creating the Exceptional Patient Experience in an Academic Health System. Academic Medicine. 2016;91(3):338–44.
    1. Arah OA, ten Asbroek AH, Delnoij DM, de Koning JS, Stam PJ, Poll AH, Vriens B, Schmidt PF, Klazinga NS. Psychometric properties of the Dutch version of the hospital-level consumer assessment of health plans survey instrument. Health Serv Res. 2006;41(1):284–301. doi: 10.1111/j.1475-6773.2005.00462.x.
    1. Dyer N, Sorra JS, Smith SA, Cleary PD, Hays RD. Psychometric properties of the consumer assessment of healthcare providers and systems (CAHPS(R)) clinician and group adult visit survey. Med Care. 2012;50(Suppl):S28–34. doi: 10.1097/MLR.0b013e31826cbc0d.
    1. Hargraves JL, Hays RD, Cleary PD. Psychometric properties of the consumer assessment of health plans study (CAHPS) 2.0 adult core survey. Health Serv Res. 2003;38(6 Pt 1):1509–27. doi: 10.1111/j.1475-6773.2003.00190.x.
    1. Hays RD, Shaul JA, Williams VS, Lubalin JS, Harris-Kojetin LD, Sweeny SF, Cleary PD. Psychometric properties of the CAHPS 1.0 survey measures. Consumer assessment of health plans study. Med Care. 1999;37(3 Suppl):MS22–31.
    1. Keller S, O’Malley AJ, Hays RD, Matthew RA, Zaslavsky AM, Hepner KA, Cleary PD. Methods used to streamline the CAHPS Hospital Survey. Health Serv Res. 2005;40(6 Pt 2):2057–77. doi: 10.1111/j.1475-6773.2005.00478.x.
    1. Westbrook KW, Babakus E, Grant CC. Measuring patient-perceived hospital service quality: validity and managerial usefulness of HCAHPS scales. Health Mark Q. 2014;31(2):97–114. doi: 10.1080/07359683.2014.907114.
    1. Fielding the CAHPS Clinician & Group Surveys []. Accessed 25 Nov 2015.
    1. Press Ganey Associates, Inc. Medical Practice Survey Psychometrics Report. South Bend: Press Ganey Associates, Inc; 2010.
    1. Press Ganey Associates, Inc. Guide to Interpreting Calculation of Scores. South Bend: Press Ganey Associates, Inc; 2010.
    1. R: A language and environment for statistical computing. R Foundation for Statistical Computing, [URL ]. Accessed 25 Nov 2015.
    1. McCarthy ML, Silberstein CE, Atkins EA, Harryman SE, Sponseller PD, Hadley-Miller NA. Comparing reliability and validity of pediatric instruments for measuring health and well-being of children with spastic cerebral palsy. Dev Med Child Neurol. 2002;44(7):468–76. doi: 10.1111/j.1469-8749.2002.tb00308.x.
    1. McHorney CA, Ware JE, Jr, Lu JF. The MOS 36-item short-form health survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care. 1994;32(1):40–66. doi: 10.1097/00005650-199401000-00004.
    1. Hattie J. Methodology review: assessing unidimensionality of tests and items. Appl Psychol Meas. 1985;9:139–64. doi: 10.1177/014662168500900204.
    1. Schmitt N. Uses and abuses of coefficient alpha. Am Psychol Assoc. 1996;8(4):350–3.
    1. Nunnally J. Psychometric theory. 2. New York: McGraw-Hill; 1978.
    1. Briggs SR, Cheek JM. The role of factor analysis in the development and evaluation of personality scales. J Pers. 1986;54(1):106–48. doi: 10.1111/j.1467-6494.1986.tb00391.x.
    1. Clark LA, Watson D. Constructing validity: basic issues in objective scale development. Psychol Assess. 1995;7(3):309–19. doi: 10.1037/1040-3590.7.3.309.
    1. Hu L, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model. 1999;6(1):1–55. doi: 10.1080/10705519909540118.
    1. Fornell C, Larcker DF. Evaluating structural equation models with unobservable variables and measurement error. J Mark Res. 1981;18(1):39–50. doi: 10.2307/3151312.
    1. Elliott MN, Zaslavsky AM, Goldstein E, Lehrman W, Hambarsoomians K, Beckett MK, Giordano L. Effects of survey mode, patient mix, and nonresponse on CAHPS hospital survey scores. Health Serv Res. 2009;44(2 Pt 1):501–18. doi: 10.1111/j.1475-6773.2008.00914.x.
    1. Elliott MN, Edwards C, Angeles J, Hambarsoomians K, Hays RD. Patterns of unit and item nonresponse in the CAHPS Hospital Survey. Health Serv Res. 2005;40(6 Pt 2):2096–119. doi: 10.1111/j.1475-6773.2005.00476.x.
    1. O’Malley AJ, Zaslavsky AM, Elliott MN, Zaborski L, Cleary PD. Case-mix adjustment of the CAHPS hospital survey. Health Serv Res. 2005;40(6 Pt 2):2162–81. doi: 10.1111/j.1475-6773.2005.00470.x.
    1. Morgan KH, Fulton BR, Kaldenberg DO, Malott DL, Ayala L, Wolosin RJ. Creating Mixed Internet and Mail Samples for Patient Satisfaction Surveys at Medical Practices. South Bend: Press Ganey Associates DoRaA; 2015.

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