Table 4. Quality of Care Composites.

Composite	Composite score, %a
	Never or sometimes	Usually	Always
Access to care compositeb
SCDIC needs assessment	41	28	31
ASCQ-Me field test	41	30	28
CAHPS adult Medicaid 2017	18	27	55
Clinician communication compositec
SCDIC needs assessment	8	16	76
ASCQ-Me field test	12	23	65
CAHPS adult Medicaid 2017	9	17	74
Access to emergency department cared
SCDIC needs assessment	55	26	19
ASCQ-Me field test	49	30	21
CAHPS adult Medicaid 2017	16	21	63

Abbreviations: ASCQ-Me, Adult Sickle Cell Quality of Life Measurement Information System; CAHPS, Consumer Assessments of Healthcare Providers and Systems; SCDIC, Sickle Cell Disease Implementation Consortium.

^aAs stated in the ASCQ-Me User’s Manual “The interpretation of the composites is less straightforward than with the individual items, since the composite score is derived by combining responses from multiple individual items.”^40(p7) With that caveat, percentages for the composites (and 1 individual item) are summarized here. For consistency with the scoring guide, categories were labeled “never or sometimes, usually, and always,” where “always” defined respondents who reported the most positive response. Note, however, that not all items were scored on this scale.

^bFor SCDIC and the ASCQ-Me field test populations, this composite was composed of the following items: “In the past 12 months, …when you tried to make an appointment to see DR/RN, how often were you able to get one as soon as you wanted; …when you needed care right away, how often did you get it as soon as you wanted; …what is the longest you had to wait before your pain was treated; and how important were bad experiences in the emergency room in your decision to avoid going for care.” For the CAHPS adult Medicaid 2017 population, this composite was composed of the following items: “How often was easy to get needed care, tests, or treatment”; and “got appointments with specialists as soon as needed.”

^cFor SCDIC and the ASCQ-Me field test populations, this composite was composed of the following items: “In the past 12 months, …how often did this doctor or nurse explain things in a way that is easy to understand; …how often did this doctor or nurse listen carefully to you; …how often did this doctor or nurse treat you with courtesy and respect; and …how often did this doctor or nurse spend enough time with you.” For the CAHPS adult Medicaid 2017 population, this composite was composed of the following items: “Personal MD …explained things clearly; …listened carefully; …respected consumer comments; and …spent enough time with consumers.”

^dFor SCDIC and the ASCQ-Me field test populations, this individual item was worded as “In the past 12 months, when you needed care right away, how often did you get it as soon as you wanted.” For the CAHPS adult Medicaid 2017 population, this item was worded as “Got urgent care for illness, injury, or condition as soon as needed.”