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Workers' Compensation & Managed Care

Measuring Consumer Satisfaction


Charles Darby, M.A., Expert Appointment, Center for Quality Measurement and Improvement, Agency for Health Care Policy and Research (AHCPR), U.S. Department of Health and Human Services, Rockville, MD.

Kathy Dervin, M.P.H., Health Education Consultant, State of California Department of Industrial Relations, Division of Workers' Compensation Managed Care Program, San Francisco, CA.

One measure of the quality of any health care delivery system is the satisfaction of the people it serves.

Charles Darby provided an overview of consumer satisfaction measurement efforts in the general health care field. He explained that consumers are not generally interested in highly technical measurements. Their areas of concern tend to be:

  • The extent of their benefits.
  • Provider choice.
  • Access to care.
  • Quality of services.
  • Costs.

He also noted that there are several challenges to gathering and reporting appropriate data, including the need to gather data in a standardized way, and the need to determine what questions to ask to get useful data.

Mr. Darby discussed the efforts of the AHCPR, through contracts with several research organizations, to develop survey methods for obtaining consumer information through the Consumer Assessment of Health Plans (CAHPS®) project. The team developing the CAHPS® survey made an effort to gather important information that consumers are interested in, while keeping the instrument short and at a low literacy level to ensure maximum participant response and comprehension. By looking at survey models in the general health care field, such as CAHPS®, analysts may find measurements that can be tailored to workers' compensation initiatives.

In the second half of the session, Kathy Dervin shared the experiences of her State's workers' compensation survey effort. In developing this mail survey, she said that the State considered the fact that workers' compensation consumers are different that other health consumers. For example, injured workers are often uninformed about the workers' compensation process, harbor anger at their employer due to the safety hazards they encountered, and tend to have low expectations.

In developing their survey instrument, the team reviewed available literature, as well as employee-focused surveys previously conducted in Florida, Washington, and New York. Her team adapted questions from these surveys, as well as from group health models, and created new questions.

The resulting study focused on areas such as:

  • Injury information.
  • Access to first treatment.
  • Overall perception of care.
  • Functional outcomes.
  • Demographics.

Although the results of the survey are still being analyzed, early results from focus groups indicate that workers are generally confused about the workers' compensation process due to a lack of information.

In closing, Ms. Dervin suggested that there were several key design questions that other States should consider when developing their own survey instruments. They include:

  • Do you know what injured workers want to know about their medical care?
  • Is it desirable to have a core set of questions, considering State differences?
  • What will be the uses of the survey by various parties (employers, unions, workers, etc.)?


What Do Injured Workers Think of Their Medical Care? Survey conducted by The Division of Workers' Compensation State of California and The Survey Research Center University of California at Berkeley.

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