Reliability of Physician-Level Measures of Patient Experience in Primary Care.

backgroundPatient experience measures are widely used to compare performance at the individual physician level.

objectiveTo assess the impact of unmeasured patient characteristics on visit-level patient experience measures and the sample sizes required to reliably measure patient experience at the primary care physician (PCP) level.

designRepeated cross-sectional design.

settingAcademic family medicine practice in California.

participantsOne thousand one hundred forty-one adult patients attending 1319 visits with 56 PCPs (including 45 resident and 11 faculty physicians). MEASUREMENTS: Post-visit patient experience surveys including patient measures used for standard adjustment as recommend by the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Consortium and additional patient characteristics used for expanded adjustment (including attitudes toward healthcare, global life satisfaction, patient personality, current symptom bother, and marital status).

resultsThe amount of variance in patient experience explained doubled with expanded adjustment for patient characteristics compared with standard adjustment (R

conclusionsWidely used methods for measuring PCP-level patient experience may not account sufficiently for influential patient characteristics. If methods were adapted to account for these characteristics, patient sample sizes for reliable between-physician comparisons may be too large for most practices to obtain.