The influence of patient characteristics on ratings of managed behavioral health care
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Despite current emphasis on consumer-based performance measures, little is known about factors that influence consumer ratings of behavioral health care. This study examines the influence of patient characteristics, health care use, and insurance coverage on patients' ratings of their managed behavioral health care in both commercial and public plans. Older and healthier patients rated their behavioral health care and health plan more highly than did other patients. Patients with less education and those whose insurance paid all costs of care gave consistently higher plan ratings. Women and frequent users enrolled in commercial plans gave more positive care ratings. After adjusting for enrollee characteristics and coverage, there were no differences between ratings of patients in commercial and public plans. These results are consistent with other research that illustrates the importance of adjusting health care ratings for patient characteristics when comparing plans.
- Eisen SV, Shaul JA, Clarridge B, et al. Development of a consumer survey for behavioral health services.Psychiatric Services. 1999;50:793–798.
- Hermann RC, Regner JL, Erickson P, et al. Developing a quality management system for behavioral healthcare: the Cambridge Alliance experience.Harvard Review of Psychiatry. 2000;8(5):251–260.
- Shaul JA, Eisen SV, Stringfellow VL, et al. Use of consumer ratings for quality improvement in behavioral health insurance plans.Joint Commission Journal on Quality Improvement. 2001;27(4):216–229.
- Aharony L, Strasser S. Patient satisfaction: what we know and what we still need to explore.Medical Care Research and Review. 1993;50:49–79.
- Cleary PD, McNeil BJ. Patient satisfaction as an indicator of quality care.Inquiry. 1988;25:25–36.
- Pascoe GC. Patient satisfaction in primary health care: a literature review and analysis.Evaluation and Program Planning. 1983;6:185–220.
- Sitzia J, Wood N. Patient satisfaction: a review of issues and concepts.Social Science and Medicine. 1997;45:1829–1843.
- Lochman JE. Factors related to patients' satisfaction with their medical care.Journal of Community Health. 1983;9:91–109.
- Rosenheck R, Wilson NJ, Meterko M. Influence of patient and hospital factors on consumer satisfaction with inpatient mental health treatment.Psychiatric Services. 1997;48:1553–1561.
- Carlson MJ, Blustein J, Fiorentino N, et al. Socioeconomic status and dissatisfaction among HMO enrollees.Medical Care. 2000;38:508–516.
- Zaslavsky AM, Zaborski LB, Ding L, et al. Adjusting performance measures to ensure equitable plan comparisons.Health Care Financing Review. 2000;22(3):109–126.
- Dow MG, Boaz TL, Thornton D. Risk adjustment of Florida mental health outcomes data: concepts, methods, and results.The Journal of Behavioral Health Services & Research. 2001;28(3):258–272.
- Hermann RC, Ettner SL, Dorwart RA. The influence of psychiatric disorders on patients' ratings of satisfaction with health care.Medical Care. 1998;36:720–727.
- Hendryx MS, Beigel A, Doucette A. Introduction: risk-adjustment issues in mental health services.The Journal of Behavioral Health Services & Research. 2001;28(3):225–234.
- Hargraves JL, Wilson IB, Zaslavsky A, et al. Adjusting for patient characteristics when analyzing reports from patients about hospital care.Medical Care. 2001;39(6):635–641.
- Carlson MJ, Gabriel RM. Patient satisfaction, use of services, and one-year outcomes in publicly funded substance abuse treatment.Psychiatric Services. 2001;52:1230–1236.
- Hendryx MS, Dyck DG, Srebnik D. Risk-adjusted outcome models for public mental health outpatient programs.Health Services Research. 1999;34:171–195.
- Hornbrook MC, Goodman MJ. Improving the AAPCC with health-status measures from the MCBS.Health Care Financing Review. 1996;17:59–75.
- Harris-Kojetin LD, Fowler FJ, Brown JA, et al. The use of cognitive testing to develop and evaluate CAHPS 1.0 core survey items.Medical Care. 1999;37:MS10-MS21.
- Hays RD, Shaul JA, Williams VSL, et al. Psychometric properties of the CAHPS 1.0 survey measures.Medical Care. 1999;37:MS22-MS31.
- Eisen SV, Shaul JA, Leff HS, et al. Toward a national consumer survey: evaluation of the CABHS and the MHSIP instruments.The Journal of Behavioral Health Services & Research. 2001;28(3):347–369.
- Zaslavsky AM, Beaulieu ND, Landon BE, et al. Dimensions of consumer assessed quality of Medicare managed-care health plans.Medical Care. 2000;38(2):162–174.
- Kolb SJ, Race KEH, Seibert JH. Psychometric evaluation of an inpatient satisfaction survey.The Journal of Behavioral Health Services & Research. 2000;27(1):75–87.
- Kalman TP. An overview of patient satisfaction with psychiatric treatment.Hospital and Community Psychiatry. 1983;34:48–54.
- Hall JA, Dornan MC. Patient sociodemographic characteristics as predictors of satisfaction with medical care: a meta-analysis.Social Science and Medicine. 1990;30:811–818.
- Harris IB, Rich EC, Crowson TW. Attitudes of internal medicine residents and staff physicians toward various patient characteristics.Journal of Medical Education. 1985;60:192–195.
- Street RL, Butler DB. Patients' characteristics affecting physician-patient nonverbal communication.Human Communication Research. 1988;15: 60–90.
- Druss BG, Rosenheck RA, Stolar M. Patient satisfaction and administrative measures as indicators of the quality of mental health care.Psychiatric Services. 1999;50:1053–1058.
- Miller RH. Healthcare organizational change: implications for access to care and its measurement.Health Services Research. 1998;33:653–677.
- Zaslavsky AM, Zaborski L, Cleary PD. Does the effect of respondent characteristics on consumer assessments vary across health plans?Medical Care Research & Review. 2000;57(3):379–394.
- Ross CE, Wheaton B, Duff RS. Client satisfaction and the organization of medical practice: why time counts.Journal of Health and Social Behavior. 1981;22:243–255.
- Hall JA, Irish JT, Roter DL. Satisfaction, gender, and communication in medical visits.Medical Care. 1994;32:1216–1231.
- Lebow J. Consumer satisfaction with mental health treatment.Psychological Bulletin. 1982;91:244–259.
- Leslie DL, Rosenheck RA. Comparing quality of mental health care for public-sector and privately insured populations.Psychiatric Services. 2000;51:650–655.
- Ries RK, Jaffe C, Comtois KA, et al. Treatment satisfaction compared with outcome in severe dual disorders.Community Mental Health Journal. 1999;35:213–221.
- The influence of patient characteristics on ratings of managed behavioral health care
The Journal of Behavioral Health Services & Research
Volume 29, Issue 4 , pp 481-489
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Author Affiliations
- 1. Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, 02115, Boston, MA
- 2. CareOregon, USA
- 3. Public Health and Preventive Medicine, Oregon Health Sciences University, USA
- 4. Center for Health Quality, Outcomes and Economic Research, EN Rogers Memorial Veterans Hospital, USA