2.4. The survey

The survey was a standard CG‐CAHPS (Clinician and Group CAHPS) survey that included the Patient‐Centered Medical Home (PCMH) supplemental item set designed to assess patient experiences with the domains of primary care that define a medical home.6 In total, there were 56 questions, including ones that asked about respondent characteristics. Questions about conceptually related issues were added to form a score for composite measures assessing ability to get timely appointments, effective clinician communication, how helpful and courteous staff were, and the clinicians' use of information. The PCMH measures were single questions about whether patients were given information about after hours care, whether the provider was informed about care received from specialists, and whether the provider asked about patients' stress, plus a two‐item composite on whether patients had been asked about their specific health goals and things that make it hard for them to take care of their health. In addition, respondents were asked to rate their clinician on a 0‐10 scale where 10 represents the best possible clinician. Questions within each composite were averaged to calculate composite scores. The four composites and the clinician rating, which are the measures recommended for use by AHRQ, plus the PCMH measures are the main foci of our analysis.7 In addition, we analyzed four individual items about topics discussed with the provider plus a 3‐item Shared Decision Making composite for those who discussed starting or stopping a medication.

The paper questionnaire was 12 pages, including a cover page and unused back page. The layout of the Internet version was as close as possible to the paper version. The exact wording of questions and the combinations of questions used in composite measures are in the Appendix S1.