Abstract
BackgroundPatient experience surveys are important tools for improving the quality of cancer services, but the representativeness of responders is a concern. Increasingly, patient surveys that traditionally used postal questionnaires are incorporating an online response option. However, the characteristics and experience ratings of online responders are poorly understood.ObjectiveWe sought to examine predictors of postal or online response mode, and associations with patient experience in the (English) Cancer Patient Experience Survey.MethodsWe analyzed data from 71,186 patients with cancer recently treated in National Health Service hospitals who responded to the Cancer Patient Experience Survey 2015. Using logistic regression, we explored patient characteristics associated with greater probability of online response and whether, after adjustment for patient characteristics, the online response was associated with a more or less critical evaluation of cancer care compared to the postal response.ResultsOf the 63,134 patients included in the analysis, 4635 (7.34%) responded online. In an adjusted analysis, male (women vs men: odds ratio [OR] 0.50, 95% confidence interval [CI] 0.46-0.54), younger (<55 vs 65-74 years: OR 3.49, 95% CI 3.21-3.80), least deprived (most vs least deprived quintile: OR 0.57, 95% CI 0.51-0.64), and nonwhite (nonwhite vs white ethnic group: OR 1.37, 95% CI 1.24-1.51) patients were more likely to respond online. Compared to postal responders, after adjustment for patient characteristics, online responders had a higher likelihood of reporting an overall satisfied experience of care (OR 1.24, 95% CI 1.16-1.32). For 34 of 49 other items, online responders more frequently reported a less than positive experience of care (8 reached statistical significance), and the associations were positive for the remaining 15 of 49 items (2 reached statistical significance).ConclusionsIn the context of a national survey of patients with cancer, online and postal responders tend to differ in their characteristics and rating of satisfaction. Associations between online response and reported experience were generally small and mostly nonsignificant, but with a tendency toward less than positive ratings, although not consistently. Whether the observed associations between response mode and reported experience were causal needs to be examined using experimental survey designs.
Highlights
Patient experience is an important aspect of quality of care [1]
Increasing age was associated with lower likelihood of online response
There was evidence for variation in the odds of online response between patients across different cancer sites, with leukemia associated with the greatest odds and lung cancer with the lowest odds of online response compared with rectal cancer
Summary
Patient experience is an important aspect of quality of care [1]. In England, the National Health Service (NHS) has embarked on major policy initiatives regarding the measurement of patient experience through nationwide surveys since 2009 [2,3]. The English Cancer Patient Experience Survey (CPES), a major nationwide survey of patients recently treated for cancer, was first undertaken in 2010. Objective: We sought to examine predictors of postal or online response mode, and associations with patient experience in the (English) Cancer Patient Experience Survey. Methods: We analyzed data from 71,186 patients with cancer recently treated in National Health Service hospitals who responded to the Cancer Patient Experience Survey 2015. After adjustment for patient characteristics, online responders had a higher likelihood of reporting an overall satisfied experience of care (OR 1.24, 95% CI 1.16-1.32). Conclusions: In the context of a national survey of patients with cancer, online and postal responders tend to differ in their characteristics and rating of satisfaction. Whether the observed associations between response mode and reported experience were causal needs to be examined using experimental survey designs
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