We aim to develop and validate a questionnaire that examines quality of care from the patient's perspective for limited-English-proficient Asian Americans (AA) of Chinese and Vietnamese descent. We will conduct focus groups of patients to identify issues important to them, with an emphasis on communication and access to care. We will then draft a questionnaire and test its validity using standard survey research methods and direct observation of patient-provider encounters. Subsequent field testing will involve face-to-face patient interviews 1 month after an outpatient visit. We will evaluate alternate modes of administration to test feasibility and to maximize response. The result of our study will be a validated, culturally sensitive, patient-centered instrument that measures health care quality for limited-English-proficient AA patients. Our research will provide a template for developing future quality measures for other vulnerable populations.
President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry. Quality First: Better Health Care for All Americans. Final Report to the President of the United States. Washington, DC: President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry; March 1998.
2.
President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry. Consumer Bill of Rights and Responsibilities. Washington, DC: President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry; November 1997.
3.
United States Bureau of the Census. Statistical Abstracts of the United States. Washington, DC: US Government Printing Office;1995.
4.
Chen MS, Hawks BL. A debunking of the myth of healthy Asian Islanders. Am J Health Promot. 1995;9:261-268.
5.
Asian / Pacific Islander Data Consortium. Asian and Pacific Islander Americans: A Profile of Socioeconomic Characteristics - 1990. San Francisco, Calif: Asian / Pacific Islander Data Consortium;1992. Profile Series 3.
6.
National Center for Health Statistics. Healthy People 2000 Review, 1997. Hyattsville, Md: Public Health Service;1997. DHHS Publications 98-1256.
7.
Miller BA, Kolonel LN, Bernstein L, et al, eds. Racial/Ethnic Patterns of Cancer in the United States 1988-1992. Bethesda, Md: National Cancer Institute;1996. NIH Publication 96-4104.
8.
Massachusetts Department of Public Health, Bureau of Health Statistics, Research and Evaluation. Division of Research and Epidemiology, Massachusetts Health Status Indicators by Race and Ethnicity. Boston, Mass; Fall 1996.
9.
Kleinman A, Eisenberg L, Good B. Culture, illness, and care: clinical lessons from anthropologic and cross-cultural research. Ann Intern Med. 1978;88:251-258.
10.
Pachter LM. Culture and clinical care, folk illness beliefs and behaviors and their implications for health care delivery. JAMA. 1994;271:690-694.
11.
Blackhall LJ, Murphy ST, Frank G, et al.Ethnicity and attitudes toward patient autonomy. JAMA. 1995;274:820-825.
12.
Cleary PD, Edgman-Levitan S, Walker JD, et al.Using patient reports to improve medical care: a preliminary report from 10 hospitals. Qual Manage Health Care. 1993;2:31-38.
13.
Gerteis M, Edgman-Levitan S, Walker JD, et al.What patients really want. Health Manage Q. 1993;15:2-6.
14.
Gerteis M, Edgman-Levitan S, Daley J, et al, eds. Through the Patient's Eyes. San Francisco, Calif: Jossey-Bass Publishers, Inc;1993.
15.
Delbanco TL. Enriching the doctor-patient relationship by inviting the patient's perspective. Ann Intern Med. 1992;116:414-418.
16.
Brown JA, Nederend SE, Hays RD, et al.Special issues in assessing the care of Medicaid recipients. Med Care. 1999;37: MS79-MS88.
17.
Cleary PD, Edgman-Levitan S, Roberts M, et al.Patients evaluate their hospital care: a national survey. Health Aff (Millwood). 1991;10:254-267.
18.
Fowler FJ Jr, Cannell CF. Using behavioral coding to identify cognitive problems with survey questions. In: Schwarz N, Sudman S, eds. Answering Questions: Methodology for Determining Cognitive and Communicative Processes in Survey Research. San Francisco, Calif: Jossey-Bass Publishers, Inc;1996:15-36.
19.
Clarridge BR, McCallum-Keeler G, Forbes P, et al.Cultural Aspects of Health Care Service Delivery to MassHealth Participants. Boston, Mass: Massachusetts Division of Medical Assistance; January 1999.
20.
Cleary PD, Edgman-Levitan S, McMullen W, et al.The relationship between reported problems and patient summary evaluations of hospital care. Qual Rev Bull. 1992;18:53-59.
21.
Zeger SL, Liang KY. Longitudinal data analysis for discrete and continuous outcomes. Biometrics. 1986;42:121-130.
22.
Joreskog KG, Sorbom D. Advances in Factor Analysis and Structural Equation Models. Cambridge, Mass: Abt Books;1979.
23.
Massagli MP, Hauser RM. Response variability in self and proxy reports of paternal and filial socioeconomic characteristics. Am J Sociol. 1983;89:420-431.
24.
Meredith LS, Siu AL. Variation and quality of self-report health data: Asians and Pacific Islanders compared with other ethnic groups. Med Care. 1995;33:1120-1131.
25.
Taira DA, Safran DG, Seto TB, et al.Asian-American patient ratings of physician primary care performance. J Gen Intern Med. 1997;12;237-242.
