DOI: 10.3886/e165241v1
title: National Survey of Healthcare Organizations and Systems Summary Public Use Datasets 2017-2018

description: The National Survey of Healthcare Organizations and Systems (NSHOS) was developed by researchers at Dartmouth College in collaboration with Harvard University; University of California, Berkeley; Mayo Clinic and the High Value Healthcare Collaborative. The NSHOS was fielded from June 2017-August 2018 with funding from the Agency for Healthcare Research and Quality's Comparative Health System Performance Initiative. This suite of nationally representative surveys aimed to characterize the structure, ownership, leadership, and care delivery capabilities of health care systems, primary and multispecialty care physician practices, and hospitals. The surveys assess ownership, mental and behavioral health, information collection for quality improvement, and ACO participation, among other topics. <br><br>Practice managers and physicians at practices and C-suite leaders at hospitals were contacted with up to four mailings with invitations to complete the survey on paper or electronically. Email and telephone outreach were conducted when possible. Most respondents completed the survey on paper. Up to three individuals in each practice were contacted for practices that had not already completed the survey.<br>These public versions of the practice and hospital surveys include a subset of survey questions and scales to prevent identification of respondents.
description: Survey weights are adjusted for non-response and are designed to allow results for our sample to be extended to the entire sampling frame, not all physician practices or hospitals nationally. The weight <b>weight_r</b> is the marginal probability of sampling a practice or hospital. In these files for public use, we use a single survey weight to avoid identifying individual respondent organizations, while the full survey accounted for the nested structure of practices and hospitals within health systems.
description: Response Rates: We sampled 4,976 practices and obtained 2,333 responses. The response rate for the practice survey is 46.9%. 143 responses were later excluded because they could not be confirmed as in our sample frame. Removing those practices, the adjusted response rate is 44.0%. <br> <br>We sampled 1,628 hospitals and obtained 757 responses for a 46.5% response rate. 18 responses were later excluded because they could not be confirmed as in our sample frame for an adjusted response rate of 45.4% for the hospital survey.
description: Presence of Common Scales: Several Likert-type scales were used.
description: We used a stratified-cluster sampling design to select healthcare systems, physician practices, and hospitals using the approach described in “O'Malley AJ, Park S. A Novel Cluster Sampling Design that Couples Multiple Surveys to Support Multiple Inferential Objectives. Health Serv Outcomes Res Methodol. 2020 Sep;20(2-3):85-110. doi: 10.1007/s10742-020-00210-y. Epub 2020 Jun 9. PMID: 33613088; PMCID: PMC7888270.” When a healthcare system was sampled, we then surveyed physician practices and hospitals owned by those systems. We stratified our sample based on ownership and composition structures, including samples of both system-owned and independent physician practices and hospitals.
description: Single-location primary and multispecialty care physician practices operating in the U.S. between 2015 and 2018 with at least three primary care physicians. Primary care physicians included family medicine, geriatrics, internal medicine, or preventive medicine specialties. <br><br>Short-term acute care and critical access hospitals operating in the U.S. between 2015 and 2018. Specialty hospitals were excluded.
description: mail questionnaire; web-based survey;