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Int J Qual Health Care. 2014 Jun;26(3):240-9. doi: 10.1093/intqhc/mzu044. Epub 2014 Apr 23.

Involving patients in detecting quality gaps in a fragmented healthcare system: development of a questionnaire for Patients' Experiences Across Health Care Sectors (PEACS).

Author information

1
Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany.
2
AQUA-Institute for Applied Quality Improvement and Research in Healthcare, Goettingen, Germany.
3
Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany.
4
Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
5
Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany AQUA-Institute for Applied Quality Improvement and Research in Healthcare, Goettingen, Germany.

Abstract

OBJECTIVE:

The purpose of this study was to develop and validate a generic questionnaire to evaluate experiences and reported outcomes in patients who receive treatment across a range of healthcare sectors.

DESIGN:

Mixed-methods design including focus groups, pretests and field test.

SETTING:

The patient questionnaire was developed in the context of a nationwide program in Germany aimed at quality improvements across the healthcare sectors.

PARTICIPANTS:

For the field test, 589 questionnaires were distributed to patients via 47 general practices.

MAIN MEASUREMENTS:

Descriptive item analyzes non-responder analysis and factor analysis (PCA). Retest coefficients (r) calculated by correlation of sum scores of PCA factors. Quality gaps were assessed by the proportion of responders choosing a response category defined as indicating shortcomings in quality of care.

RESULTS:

The conceptual phase showed good content validity. Four hundred and seventy-four patients who received a range of treatment across a range of sectors were included (response rate: 80.5%). Data analysis confirmed the construct, oriented to the patient care journey with a focus on transitions between healthcare sectors. Quality gaps were assessed for the topics 'Indication', including shared-decision-making (6 items, 24.5-62.9%) and 'Discharge and Transition' (10 items; 20.7-48.2%). Retest coefficients ranged from r = 0.671 until r = 0.855 and indicated good reliability. Low ratios of item-non-response (0.8-9.3%) confirmed a high acceptance by patients.

CONCLUSIONS:

The number of patients with complex healthcare needs is increasing. Initiatives to expand quality assurance across organizational borders and healthcare sectors are therefore urgently needed. A validated questionnaire (called PEACS 1.0) is available to measure patients' experiences across healthcare sectors with a focus on quality improvement.

KEYWORDS:

measurement of quality; patient satisfaction; patient-centered care; quality improvement; quality management; quality measurement

PMID:
24758750
PMCID:
PMC4041096
DOI:
10.1093/intqhc/mzu044
[Indexed for MEDLINE]
Free PMC Article

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