RESUMEN
BACKGROUND: Evaluation of patients' health care experiences is central to measuring patient-centred care. However, different instruments tend to be used at the hospital or departmental level but rarely both, leading to a lack of standardization of patient experience measures. OBJECTIVE: To validate the Consumer Quality Index (CQI) Inpatient Hospital Care for use on both department and hospital levels. DESIGN: Using cross-sectional observational data, we investigated the internal validity of the questionnaire using confirmatory factor analyses (CFA), and the generalizability of the questionnaire for use at the department and hospital levels using generalizability theory. SETTING AND PARTICIPANTS: 22924 adults hospitalized for ≥24 hours between 1 January 2013 and 31 December 2014 in 23 Dutch hospitals (515 department evaluations). MAIN VARIABLE: CQI Inpatient Hospital Care questionnaire. RESULTS: CFA results showed a good fit on individual level (CFI=0.96, TLI=0.95, RMSEA=0.04), which was comparable between specialties. When scores were aggregated to the department level, the fit was less desirable (CFI=0.83, TLI=0.81, RMSEA=0.06), and there was a significant overlap between communication with doctors and explanation of treatment subscales. Departments and hospitals explained ≤5% of total variance in subscale scores. In total, 4-8 departments and 50 respondents per department are needed to reliably evaluate subscales rated on a 4-point scale, and 10 departments with 100-150 respondents per department for binary subscales. DISCUSSION AND CONCLUSIONS: The CQI Inpatient Hospital Care is a valid and reliable questionnaire to evaluate inpatient experiences in Dutch hospitals provided sufficient sampling is done. Results can facilitate meaningful comparisons and guide quality improvement activities in individual departments and hospitals.
Asunto(s)
Satisfacción del Paciente , Calidad de la Atención de Salud/organización & administración , Encuestas y Cuestionarios/normas , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Comunicación , Estudios Transversales , Análisis Factorial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Atención Dirigida al Paciente/organización & administración , Relaciones Médico-Paciente , Psicometría , Indicadores de Calidad de la Atención de Salud , Calidad de la Atención de Salud/normas , Reproducibilidad de los Resultados , Estudios Retrospectivos , Adulto JovenRESUMEN
BACKGROUND: Accounting for patients' perspective has become increasingly important. Based on the Consumer Quality Index method (founded on Consumer Assessment of Healthcare Providers and Systems) a questionnaire was recently developed for Dutch cancer patients. As a next step, this study aimed to adapt and pilot this questionnaire for international comparison of cancer patients experience and satisfaction with care in six European countries. METHOD: The Consumer Quality Index was translated into the local language at the participating pilot sites using cross-translation. A minimum of 100 patients per site were surveyed through convenience sampling. Data from seven pilot sites in six countries was collected through an online and paper-based survey. Internal consistency was tested by calculating Cronbach's alpha and validity by means of cognitive interviews. Demographic factors were compared as possible influencing factors. RESULTS: A total of 698 patients from six European countries filled the questionnaire. Cronbach's alpha was good or satisfactory in 8 out of 10 categories. Patient satisfaction significantly differed between the countries. We observed no difference in patient satisfaction for age, gender, education, and tumor type, but satisfaction was significantly higher in patients with a higher level of activation. CONCLUSION: This European Cancer Consumer Quality Index(ECCQI) showed promising scores on internal consistency (reliability) and a good internal validity. The ECCQI is to our knowledge the first to measure and compare experiences and satisfaction of cancer patients on an international level, it may enable healthcare providers to improve the quality of cancer care.