Health Services Research, Part 2: Types of Surveys + Outcomes
by Susan Dess, 3.29.17
Surveying the individuals an organization serves can be an important component of several aspects of healthcare management. Various kinds of surveys correspond to the specific information needs of a healthcare organization during different moments of care delivery.
Health Risk Assessment and Member Satisfaction Surveys
For example, a health risk assessment is designed to collect descriptive information about an individual, including: health history, special needs for accessibility and communication, and personal healthcare goals and preferences.
Member satisfaction surveys are also a well-known kind of survey commonly used in health services research. These are created to generate information about a person’s feelings about the services he or she is receiving. The results are often beneficial in determining which groups of the overall population served are less happy with their experience and why.
Health Outcomes Survey
Organizations can then use the findings to course-correct and determine how to better serve their customers. Another important type of survey healthcare organizations use is a health outcomes survey. This survey is focused on evaluating how much change has occurred to a person’s health during his or her treatment by the agency.
These outcomes can be grouped in several categories:
• Knowledge (To what extent has the person learned about health problems and treatments),
• Behaviors (To what extent has there been a change in the person’s practices),
• Beliefs/Feelings (To what extent has a person’s opinions, beliefs, and values changed), or
• Clinical Indicators (To what extent has change occurred to a person’s specific health indicators)
For example, if a healthcare organization wants to learn about its customers’ diet and eating habits, it may need to collect survey data on all of these levels:
• Knowledge – How much does the person know about the impact of diet on personal health?
• Behavioral – How much and how often does the person consume certain types of healthy and unhealthy food and beverage options?
• Beliefs/Feelings – How does the person feel about various aspects of diet and nutrition?
• Clinical Indicators – Has the person’s weight, blood pressure, activities of daily living (ADL), etc., changed?
What's the Difference?
Of course, there are some important differences between surveying to assess health risks or to assess member satisfaction and surveying to evaluate health outcomes. The first two may be cross-sectional, in that they only require information be gathered at one point in time. Sometimes data is collected more than once, but it is not necessary to do so for these surveys to be helpful to an organization.
Surveys designed to measure health outcomes should be longitudinal, meaning the organization needs to collect information on the same items from people at two points in time which allows them to compare the same individuals to themselves over time.
For example, a satisfaction survey may show that 80% of people surveyed in June are satisfied with the customer service of the front office staff (this is an example of a beliefs/feelings item on a survey). The agency can determine, based on this one survey whether to act to increase this number. However, results of satisfaction surveys can be also be compared to each other time to demonstrate trends for the population served by the organization.
For example, if the survey described above shows in December that the percentage of satisfied individuals dropped to 60%, this could affect the agency’s decision as to if it should undertake a specific program to improve its customer service in the front office.
Basic Statistical Procedure
For measuring health outcomes with surveys, when the same person has been surveyed using all the exact same questions at two points in time, a basic statistical procedure known as a T-test for Paired Samples can be used to determine if any changes to for the group served are statistically significant. This statistic can easily be calculated using Microsoft Excel, and does not required complex data analysis software to generate.
Aday, Lu Ann and Llewellyn J. Cornelius, 2006. “Designing and Conducting Health Surveys: A Comprehensive Guide,” Jossey-Bass: San Francisco, CA.
Focusing specifically on developing surveys for HSR studies designed to measure health outcomes, the entries that follow in this series detail more specifically how to create surveys that successfully measure health outcomes:
> Creating meaningful research questions
> Conceptualizing and operationalizing variables
> Developing sophisticated survey questions
Part 1: Introduction to Health Services Research
As an experienced health care professional, Susan (Sue) Dess brings a wide range of experiences to Crestline. Her 15 year administrative and executive management background spans the operations of both managed care and provider organizations.
Additionally, Sue spent 25 years as an Emergency Room and Intensive Care Registered Nurse, further rounding out her ability to understand the "big picture." Sue is intimately involved with each Crestline project, collaborating closely with consultants and clients.