This study examined whether health confidence is associated with consumers' ratings and reports of care and whether adjusting for health confidence and other factors attenuates ethnic or racial ...disparities. Data are from the 2005 Medical Expenditure Panel Survey. Persons with greater health confidence had lower adjusted odds of high overall care ratings (OCRs) and high reports of getting needed care and provider communication. Adjusting for health confidence and other factors, there were no Hispanic/non-Hispanic differences. Compared with whites, African Americans had lower OCRs and reports of getting needed care; Asians had lower OCRs and reports of getting needed care, getting care quickly, and provider communication. Health care organizations and providers should consider targeting improvement efforts toward health-confident persons and adjusting for health confidence when comparing consumer assessments across groups. Although health confidence is associated with consumer assessments, other factors explain racial and ethnic differences.
This article reports on the work of the New York State Office of Mental Health Downstate Alliance, which is comprised of eight psychiatric centers that have formed a consortium to create new ...initiatives and solve common problems. The first of these initiatives are the inpatient and outpatient versions of the Consumer Assessments of Care, which assess satisfaction with care and quality of life (QOL). Consumers from peer run organizations who administered the survey used a mixed-mode administration method, which leveraged the strengths of the personal interview and anonymous self-report methods. Inpatients reported realistic levels of satisfaction and showed areas for improvement for inpatient units across facilities. Outpatients were considerably more satisfied with care, but ratings were lower on the work and community involvement dimensions of QOL. Factor analyses indicated that a one-factor model, satisfaction with care, fit the data well for the inpatient survey. A two-factor solution, satisfaction with care and QOL, was successfully fit to the outpatient data. Internal consistency reliability levels were excellent for both assessments.
