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Intensive Efforts Can Drive Health Care Survey Response Rates Over 50%

*Marc N Elliott, RAND Corporation 
Sara Toomey, Boston Children’s Hospital  
David J Klein, Boston Children's Hospital 
Julie Brown, RAND Corporation 
Alan M Zaslavsky, Harvard Medical School 
Mark W Schuster, Boston Children’s Hospital 

Keywords: Survey Research, Child and Adolescent Health

Low response rates for hard-to-reach populations pose challenges in patient surveys. We evaluated five intensive survey modes in a randomized experiment compared to a standard survey mode using Child HCAHPS®, a patient experience survey for parents of recent pediatric inpatients. Parents of 3,873 pediatric patients were randomized to each of six conditions representing combinations of $20 incentive (present/absent) and survey mode (USPS mail followed by phone, FedEx overnight followed by phone, email followed by FedEx followed by phone). The standard condition (mail/phone + no incentive) had a 29% response rate, compared to 59% for email/FedEx/phone + incentive and 54% for FedEx/phone + incentive. The mean effect of the incentive (vs. none) was 15%, of email/FedEx/phone (vs. standard) was 13%, and of FedEx/phone (vs. standard) was 12% (p<0.001 for each); the incentive effect was additive with the mode effect (p>0.05). Effects did not differ by race/ethnicity/language, age, admission source, and ICU status. A combination of FedEx and incentives can boost response rates by =25% to more than 50%. Starting with email is as effective and less expensive, eliminating about half of the need for FedEx.