International Journal for Quality in Health Care Advance Access originally published online on October 15, 2008
International Journal for Quality in Health Care 2009 21(1):51-57; doi:10.1093/intqhc/mzn046
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Patients' perspective in Chilean primary care: a questionnaire validation study
Family Medicine Department, School of Medicine, Pontificia Universidad Católica de Chile
Objective. The aim of this study was to adapt and validate an instrument for assessing quality of care from the patients' perspective in the context of Chilean primary care.
Methods. The Health Centre Assessment Questionnaire is made up of six multiple-item scales and two single-item scales addressing eight key areas of primary care activity. A further two single-item scales ask about the overall satisfaction and the way in which the centre deals with patients' health issues. The adaptation process was developed according to methods described in the specialized literature. The instrument was initially pre-tested in a sample of 100 primary care patients. The validation was carried out in 10 urban public primary healthcare centres where 2896 patients were invited to complete the questionnaire. The validity and reliability of the instrument was assessed using standard psychometric techniques.
Results. Ninety nine per cent (2870) of those approached completed the questionnaire. It was acceptable to most of the patients as reflected by the high response rate, and a full range of possible scores in most of the scales. Reliability was good as reflected by high internal consistency and homogeneity. Validity was supported by the confirmation of scaling assumptions, the moderate correlations between multiple-item scales, and by the confirmation of our a priori hypothesis.
Conclusions. The questionnaire could be a useful instrument for assessing a number of important dimensions in Chilean primary care. It is acceptable, reliable and valid. Further work is required to evaluate its validity against external criteria and its test–retest reliability.
Keywords: GPs, primary care, quality questionnaire, middle-income country, psychometrics, validation studies
Address reprint requests to: Tomas Pantoja, Tel: +56 2 3548111; Fax: +56 2 3543398; E-mail: tpantoja{at}med.puc.cl
Accepted for publication September 6, 2008.