Nonresponse bias in a survey of patient perceptions of hospital care.

Abstract:

BACKGROUND:Incomplete participation is of particular concern for surveys of patient perceptions of care because patients who have negative opinions may be least likely to participate. OBJECTIVE:We sought to examine indirect evidence of nonresponse bias. DESIGN:We re-analyzed data from a cross-sectional patient survey. SUBJECTS:Our subjects were patients discharged from a Swiss hospital (n = 2156). MEASURES:We measured the following: (1) an observed problem score, based on 15 key items of the Picker Patient Experience questionnaire, (2) a predicted problem score, and (3) a participation propensity score. The latter scores were computed for all eligible patients, including those who did not return the survey, from routinely available baseline data. RESULTS:The participation rate was 70% (n = 1518), and the mean problem score was 29.9 (SD 23.8). Early respondents reported significantly fewer problems than late respondents (28.6 versus 32.9, P = 0.001). Participation propensity scores were progressively lower in early respondents (mean 74.2), late respondents (70.7), and nonrespondents (63.9, P < 0.001); the pattern was similar for predicted problem scores (early respondents: 29.5; late respondents: 30.5; nonrespondents: 33.4, P < 0.001). The propensity to participate was negatively associated with the problem score (Pearson r = -0.19). Finally, predictors of participation were similar to predictors of problem scores. CONCLUSIONS:The tendency to participate in the survey was negatively associated with the report of problems during hospitalization. Nevertheless, increasing participation from 30% to 70% had only a modest influence on the final conclusions of the survey.

journal_name

Med Care

journal_title

Medical care

authors

Perneger TV,Chamot E,Bovier PA

doi

10.1097/01.mlr.0000156856.36901.40

keywords:

subject

Has Abstract

pub_date

2005-04-01 00:00:00

pages

374-80

issue

4

eissn

0025-7079

issn

1537-1948

pii

00005650-200504000-00008

journal_volume

43

pub_type

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