Differential Use of 0-10 Rating Scales by Racial-Ethnic Minorities in CAHPS®

• Activity Number: 188
• Type: Topic Contributed
• Date/Time: Monday, August 7, 2006 : 2:00 PM to 3:50 PM
• Sponsor: Section on Health Policy Statistics
• Author(s): Robert Weech-Maldonado*+ and Marc Elliott and K. Cameron Schiller and Ron D. Hays
• Companies: University of Florida and RAND Corporation and University of Florida and University of California, Los Angeles
• Keywords: race/ethnicity ; consumer assessments ; Medicaid ; rating scales

Abstract

Understanding cultural differences in the use of rating scales is critical to evaluating racial/ethnic disparities in consumer assessments of care. The Consumer Assessments of Healthcare Providers and Systems (CAHPS®) survey uses four 0-10 global ratings (i.e., personal doctor, specialist, plan, and health care), among other measures. Using multinomial logistic regression on more than 31,622 Medicaid and 229,790 commercial managed care enrollees in 2000, we find evidence that Hispanic ethnicity and Medicaid status are both associated with increased endorsement of "10" relative to an omitted category of "5"-"8" after case-mix adjusting for age, gender, education, and self-rated health status. Because of the negative skew, what actually may be a difference in dispersion or use of scale extremes may be misinterpreted as a difference in central tendency.