PS1-34: Sensitivity of Patient-reported Physician Percentile Rankings to Inter-physician Variability and Patient Sample Size

Abstract

Background/Aims Patient satisfaction is increasingly being recognized as a desirable measure of physician quality and is used for quality-based financial incentives. Patient satisfaction surveys such as the CAHPS, however, typically exhibit ‘ceiling effects’ where most patients report maximal satisfaction, and so physicians are often ranked based on their percentage of maximum-satisfaction responses (“percentile top box scores,” 0–100%) rather than on raw scores. Even so, physicians express concern that low response rates or tight clustering of underlying scores can have unknown effects on rankings and detrimental consequences. This study used simulation to report the effect of inter-physician variability and sample size on survey-based physician rankings.