Racial/Ethnic and Language Differences in Patient Experiences with Hospital Inpatient Care

Patient assessments of health care, such as the standardized surveys developed in the Consumer Assessments of Healthcare Providers and Systems (CAHPS®) are increasingly being used as an indicator of the quality of care provided by health plans and health care providers. This study uses hospital CAHPS data to analyze whether patient assessments of hospital care vary by race/ethnicity and language.

Data consist of the California Hospital Assessment and Reporting Taskforce (CHART) Patient Experience Survey for 2006. The survey was mailed to a random sample of 750 recently discharged patients from each of the 200 participating hospitals (51% of eligible hospitals). The dependent variables are the CAHPS Hospital Survey's reports and an overall rating of hospital inpatient care. There are 22 report items in the survey that assess seven domains of care: communication with doctors, communication with nurses, responsiveness of hospital staff, cleanliness and noise level of the physical environment, pain control, communication about medicines, and discharge information. The independent variables consist of patient characteristics: race/ethnicity (Hispanics, American Indian, African-American, Asian, Pacific Islanders, White, and Multiracial), primary language (English, Spanish, or Other), education (8th grade or less, some high school, high school graduate, and 1 or more years of college), self-rated health (excellent, very good, good, fair, and poor), type of admission (medical or surgical), and length of stay. Multivariate regression is used to analyze the data. Standard errors are adjusted for correlation within hospitals using the Huber/White correction.