Development and Evaluation of the CAHPS® Hospital Survey

This special issue of Health Services Research is intended to provide the reader with technical documentation of the development and testing of the CAHPS Hospital Survey and on the decisions that shaped the final product.In addition, it gives readers a sense of the steps involved and the various factors to be considered in developing a survey for widespread use.CAHPS surveys are used by health care decision makers to help them make informed choices of health care providers.For example, the CAHPS Health Plan Survey is used by a wide variety of organizations, including the National Committee for Quality Assurance, Centers for Medicare and Medicaid Services, state Medicaid programs, Department of Defense, purchasing coalitions, and health plans for a wide variety of purposes, including informing consumers, accrediting health plans, assuring accountability, monitoring performance, and identifying quality improvement targets.Because CAHPS data are used to inform various health care decisions described above, the development of the CAHPS surveys must incorporate input from a wide range of stakeholders to ensure that the final product will meet the needs of those decision makers.In addition, rigorous scientific methods need to be applied in the development and evaluation of CAHPS data to ensure that the products are credible and useful.The first article in the special issue by Elizabeth Goldstein and colleagues provides an overview of the process to solicit input on the content of the questionnaire and the methods for sampling, data collection, and analysis.Input from stakeholders was garnered through a variety of venues, including a literature review, one-on-one meetings, focus groups with target consumers, and issuance of Federal Register Notices.Obtaining this information was critical for the CAHPS Hospital Survey because the hospital industry already has a number of surveys to measure patients' level of satisfaction and their assessment of quality of care.The information allowed the team to develop a CAHPS Hospital Survey that could be integrated with the existing surveys conducted by hospitals, while providing sufficient standardization to ensure valid comparisons among hospitals.