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      Confirmatory factor analysis of the Consumer Assessment of Health Plans Study (CAHPS) 1.0 core survey.

      , , , ,
      Psychological Assessment
      American Psychological Association (APA)

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          Abstract

          The National Consumer Assessment of Health Plans Study (CAHPS) Benchmarking Database was used to assess the factor structure and invariance of the CAHPS 1.0 Core Survey. Separate analyses were conducted with Latino and non-Latino Caucasian consumers drawn from commercial and Medicaid sectors (N = 15,092). Results demonstrated that the 23 CAHPS 1.0 report items measure consumer reports of experiences with 5 aspects of health plan performance: Access to Care, Timeliness of Care, Provider Communication, Health Plan Consumer Service, and Office Staff Helpfulness. Four items assessed global ratings of care. Analyses revealed an identical pattern of fixed and free factor loadings across all samples. Magnitude of factor loadings and correlations among factors was essentially equivalent within a common health service sector. A higher order factor analysis revealed that rating and reports of care showed marked convergence.

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          The Performance of ML, GLS, and WLS Estimation in Structural Equation Modeling Under Conditions of Misspecification and Nonnormality

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            Measures of Multivariate Skewness and Kurtosis with Applications

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              Antecedents of adherence to medical recommendations: results from the Medical Outcomes Study.

              A longitudinal study of patients with chronic medical diseases (hypertension, diabetes, heart disease) was conducted to identify antecedents of adherence to medical recommendations. Data are from 1198 patients in three health-care provision systems in Los Angeles, Chicago, and Boston. Nonadherence at the beginning of the study was the strongest predictor of nonadherence 2 years later. Other significant predictors varied by type of adherence outcome. Patients who were younger and who relied upon avoidant coping strategies tended to be less likely to follow their doctor's specific recommendations. Patients who were distressed about their health, used avoidant coping strategies, or who reported worse physical and role functioning were less likely to adhere in general. Patient satisfaction with two features of care (interpersonal quality and financial aspects) was positively related to adherence in some models, but satisfaction with the technical quality of care was negatively associated with adherence to specific recommendations among heart disease patients. Social support contributed to specific adherence among diabetic patients. Implications of the study for medical care providers are discussed.
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                Author and article information

                Journal
                Psychological Assessment
                Psychological Assessment
                American Psychological Association (APA)
                1939-134X
                1040-3590
                June 2001
                June 2001
                : 13
                : 2
                : 216-229
                Article
                10.1037/1040-3590.13.2.216
                1781360
                11433796
                96c4d771-91a0-4fdb-a882-8b431aadff36
                © 2001
                History

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