Article Text

Original research
Translation, adaptation and validation of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) for use in Japan: a multicentre cross-sectional study
  1. Takuya Aoki1,2,
  2. Yosuke Yamamoto3,
  3. Tomoaki Nakata4
  1. 1Division of Clinical Epidemiology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
  2. 2Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
  3. 3Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Kyoto, Japan
  4. 4Hakodate Goryoukaku Hospital, Hakodate, Hokkaido, Japan
  1. Correspondence to Dr Takuya Aoki; taoki{at}


Objectives The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a well-established and internationally recognised scale for measuring patients’ 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 Multicentere cross-sectional study.

Setting A total of 48 hospitals in Japan.

Participants 6522 patients aged ≥16 years who were discharged from the participating hospitals.

Results 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 The Japanese HCAHPS has acceptable psychometric properties for assessing patients’ experience with hospital inpatient care. This scale could be used for quality improvement based on the assessment of patients’ experience with hospital care and for health services research in Japan.

  • general medicine (see internal medicine)
  • quality in health care
  • organisation of health services

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  • Contributors TA designed the study and participated in the implementation, data analysis and writing of the manuscript. YY contributed to the design of the study and critically reviewed the manuscript. TN contributed to the design of the study, data collection and critically reviewed the manuscript. All authors gave the final approval of the manuscript before submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the Ethics Committee of Kyoto University Graduate School of Medicine (approval number R2331) and was conducted in accordance with the Declaration of Helsinki. Oral consent was obtained from each participant before participating in the survey.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available. Additional unpublished data is still being analyzed for another research and only available to the members of the study team.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.