Translation, adaptation, and validation of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) for use in Japan: A multicenter cross-sectional study

Objectives: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a well-established and internationally recognized scale for measuring patient experience with hospital inpatient care. This study aimed to develop a Japanese version of the HCAHPS and to examine its structural validity, criterion-related validity, and internal consistency reliability. Design. Multicenter cross-sectional study. Setting. A total of 48 hospitals in Japan. Participants. Patients aged ≥ 16 years who were discharged from the participating hospitals. Results. We translated the HCAHPS into Japanese according to the guidelines. Psychometric properties were examined using data from 6,522 patients. A confirmatory factor analysis showed excellent goodness of fit of the same factor structure as that of the original HCAHPS, with the following composites: communication with nurses, communication with doctors, responsiveness of hospital staff, hospital environment, communication about medicines, and discharge information. All hospital-level Pearson correlation coefficients between the Japanese HCAHPS composites and overall hospital rating exceeded the criteria. Results of inter-item correlations indicated adequate internal consistency reliability. Conclusions. We developed the Japanese HCAHPS, and evaluated its structural validity, criterion-related validity, and internal consistency reliability. This scale could be used for quality improvement based on the assessment of patient experience with hospital care and for health services research in Japan.