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Int J Qual Health Care. 2011 Jun;23(3):258-68. doi: 10.1093/intqhc/mzr019. Epub 2011 Apr 30.

A brief questionnaire for assessing patient healthcare experiences in low-income settings.

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  • 1Yale University School of Public Health, New Haven, CT 06520-8034, USA.



The aim of this study was to develop and to assess the validity and reliability of two brief questionnaires for assessing patient experiences with hospital and outpatient care in a low-income setting.


Using literature review and data from focus groups (n = 14), we developed questionnaires to assess patient experiences with inpatient (I-PAHC) and with outpatient (O-PAHC) care in a low-income setting. Questionnaires were administered in person by trained interviewers. Construct validity was assessed with factor analysis; convergent validity was assessed by correlating summary scores for each scale with overall patient evaluations, and reliability was assessed with Cronbach's alpha coefficients.


Eight health facilities in Ethiopia.


Patients >18 years old who had a hospital stay >1 day (n = 230), and patients who received outpatient care (n = 486).


Patient evaluations of health care experiences.


The factor analysis revealed 12 items that loaded on five factors for the I-PAHC questionnaire. The O-PAHC showed similar results with 13 items that loaded on four factors. Summary scores for nearly all factors were significantly associated (P-value < 0.05) with the patient's overall evaluation score. The measure of reliability, Cronbach's alpha coefficients, showed good to excellent internal consistency for all scales.


The I-PAHC on O-PAHC questionnaires can be useful in assessing patients' evaluations of care delivery in low-income settings. The questionnaires are brief and can be integrated into health systems strengthening efforts with the support of leadership at the health facility and the country levels.

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