The European Journal of Public Health Advance Access originally published online on March 8, 2006
The European Journal of Public Health 2006 16(6):652-659; doi:10.1093/eurpub/ckl023
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Health Services Research |
Made in the USA: the import of American Consumer Assessment of Health Plan Surveys (CAHPS®) into the Dutch social insurance system
Diana M. J. Delnoij1, Guus ten Asbroek2, Onyebuchi A. Arah2, Johan S. de Koning2, Piet Stam3, Aldien Poll4, Barbara Vriens4, Paul Schmidt4 and Niek S. Klazinga2
1 NIVEL (Netherlands institute for health services research), PO Box 1568, 3500 BN Utrecht, The Netherlands
2 Academic Medical Centre of the University of Amsterdam, Department of Social Medicine, PO Box 22660, 1100 DD Amsterdam, The Netherlands
3 Agis Zorgverzekeringen/Erasmus University Rotterdam, Institute of Health Policy and Management, PO Box 1738, 3000 DR Rotterdam, The Netherlands
4 Agis Zorgverzekeringen, PO Box 19, 3800 HA Amersfoort, The Netherlands
Correspondence: Diana M. J. Delnoij, NIVEL (Netherlands institute for health services research), PO Box 1568, 3500 BN Utrecht, The Netherlands, tel: +31 30 2729847, fax: +31 30 2729729, e-mail: d.delnoij{at}nivel.nl
Background: In the Netherlands, managed competition between health plans has been introduced. For Dutch health plans this implies that they need to collect data about their own performance and that of the care providers they contract. To that end, Consumer Assessment of Health Plan Surveys (CAHPS) instruments have recently been adopted by a large Dutch health plan. Objectives: This paper presents the results of a validation study of the Dutch version of the CAHPS Adult Commercial questionnaire. The questions addressed are as follows: Can this questionnaire be adapted for use in the context of the Dutch insurance system? and Can it generate valid information about the quality of health care and the performance of Dutch health plans? Methods: The translated questionnaire has been mailed to a sample of 977 enrollees. The psychometric properties of the translated instrument have been studied, and the results have been compared with those of other Dutch and American studies. Results: The net response rate was 51% (n = 500). In general, the questionnaires were filled out completely and consistently. Principal component analyses revealed a factor that can be labelled as patient-centredness in the primary process. It contains the domains that in the CAHPS literature are described as ‘courteous/helpful staff’ and ‘doctors communicating well’. Conclusions: The translated version of the CAHPS Adult Commercial questionnaire is a promising tool for Dutch health plans. More research is needed on the external and the content validity of these questionnaires in the Dutch context.
Keywords: health services research, patient satisfaction, questionnaire development, social insurance