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Measuring patient experiences with diabetes care in The Netherlands: the validity of a new survey instrument.
Asbroek, G. ten, Delnoij, D.M.J., Arah, O.A., Sixma, H., Koning, J.S. de, Rupp, I., Poll, A., Stam, P.J.A., Schmidt, P., Vriens, B., Klazinga, N.S. Measuring patient experiences with diabetes care in The Netherlands: the validity of a new survey instrument. European Journal of Public Health: 2005, 15(Suppl. 1) 142. Abstract. 13th Annual EUPHA Meeting "Promoting the public's health: reorienting health policies, linking health promotion and health care", Graz, 10-12 November 2005.
Background: The introduction of market mechanisms in Dutch healthcare engages insurance companies in competition. Patient experience surveys are increasingly applied to generate performance information
guiding consumers and insurers to choose and contract high performers, as well as holding them
accountable. Thus, there is an increased need for standardized patient experience measurement tools
for specific types of care. Here, we report on the reliability and validity of a new instrument we
developed to measure patient experiences with diabetes care. Methods: We combined and adapted
existing CAHPS and QUOTE-Diabetes instruments into one self-administered questionnaire (118 items)
to assess (i) patients’ experiences with diabetes care provided by their general practitioner (GP),
internist, nurse, or dietician and (ii) their diabetes-specific health outcomes. Survey population diabetes patients of one insurer (Agis), enrolled in the sickness fund and aged 50 or above. Sample 983 patients who claimed reimbursement for diabetes medication in the 12 months prior to November 2003 were sent a questionnaire. Results: A total of 563 patients returned the questionnaire and confirmed being diabetic (response rate 63.5%). 510 diabetes patients completed the questionnaire. Non-response bias was unlikely. Filling out the questionnaire did not seem a problem for the majority of respondents. Psychometric properties of the questionnaire compared well with the two underlying pre-existing questionnaires. ‘Diabetes specific communication’ was a consistent 4-item factor in the new instrument, independent of the type of care provider. Internal consistency reliability was good (Cronbach’s alpha ranged 0.84–0.89). ‘Provider-patient interaction’ was a consistent 5-item factor for care by GP’s, internists and nurses (Cronbach’s alpha 0.89–0.92), but not dieticians. Respondents reported case management and outcome measures similar to those in other studies. Conclusions: The newly constructed—CAHPS and QUOTE-Diabetes based—questionnaire is reliable and valid and is well received by respondents. It offers a strong basis for further development of patient experiences survey for Diabetes Care in the Dutch healthcare context. (aut.ref.)
guiding consumers and insurers to choose and contract high performers, as well as holding them
accountable. Thus, there is an increased need for standardized patient experience measurement tools
for specific types of care. Here, we report on the reliability and validity of a new instrument we
developed to measure patient experiences with diabetes care. Methods: We combined and adapted
existing CAHPS and QUOTE-Diabetes instruments into one self-administered questionnaire (118 items)
to assess (i) patients’ experiences with diabetes care provided by their general practitioner (GP),
internist, nurse, or dietician and (ii) their diabetes-specific health outcomes. Survey population diabetes patients of one insurer (Agis), enrolled in the sickness fund and aged 50 or above. Sample 983 patients who claimed reimbursement for diabetes medication in the 12 months prior to November 2003 were sent a questionnaire. Results: A total of 563 patients returned the questionnaire and confirmed being diabetic (response rate 63.5%). 510 diabetes patients completed the questionnaire. Non-response bias was unlikely. Filling out the questionnaire did not seem a problem for the majority of respondents. Psychometric properties of the questionnaire compared well with the two underlying pre-existing questionnaires. ‘Diabetes specific communication’ was a consistent 4-item factor in the new instrument, independent of the type of care provider. Internal consistency reliability was good (Cronbach’s alpha ranged 0.84–0.89). ‘Provider-patient interaction’ was a consistent 5-item factor for care by GP’s, internists and nurses (Cronbach’s alpha 0.89–0.92), but not dieticians. Respondents reported case management and outcome measures similar to those in other studies. Conclusions: The newly constructed—CAHPS and QUOTE-Diabetes based—questionnaire is reliable and valid and is well received by respondents. It offers a strong basis for further development of patient experiences survey for Diabetes Care in the Dutch healthcare context. (aut.ref.)
Background: The introduction of market mechanisms in Dutch healthcare engages insurance companies in competition. Patient experience surveys are increasingly applied to generate performance information
guiding consumers and insurers to choose and contract high performers, as well as holding them
accountable. Thus, there is an increased need for standardized patient experience measurement tools
for specific types of care. Here, we report on the reliability and validity of a new instrument we
developed to measure patient experiences with diabetes care. Methods: We combined and adapted
existing CAHPS and QUOTE-Diabetes instruments into one self-administered questionnaire (118 items)
to assess (i) patients’ experiences with diabetes care provided by their general practitioner (GP),
internist, nurse, or dietician and (ii) their diabetes-specific health outcomes. Survey population diabetes patients of one insurer (Agis), enrolled in the sickness fund and aged 50 or above. Sample 983 patients who claimed reimbursement for diabetes medication in the 12 months prior to November 2003 were sent a questionnaire. Results: A total of 563 patients returned the questionnaire and confirmed being diabetic (response rate 63.5%). 510 diabetes patients completed the questionnaire. Non-response bias was unlikely. Filling out the questionnaire did not seem a problem for the majority of respondents. Psychometric properties of the questionnaire compared well with the two underlying pre-existing questionnaires. ‘Diabetes specific communication’ was a consistent 4-item factor in the new instrument, independent of the type of care provider. Internal consistency reliability was good (Cronbach’s alpha ranged 0.84–0.89). ‘Provider-patient interaction’ was a consistent 5-item factor for care by GP’s, internists and nurses (Cronbach’s alpha 0.89–0.92), but not dieticians. Respondents reported case management and outcome measures similar to those in other studies. Conclusions: The newly constructed—CAHPS and QUOTE-Diabetes based—questionnaire is reliable and valid and is well received by respondents. It offers a strong basis for further development of patient experiences survey for Diabetes Care in the Dutch healthcare context. (aut.ref.)
guiding consumers and insurers to choose and contract high performers, as well as holding them
accountable. Thus, there is an increased need for standardized patient experience measurement tools
for specific types of care. Here, we report on the reliability and validity of a new instrument we
developed to measure patient experiences with diabetes care. Methods: We combined and adapted
existing CAHPS and QUOTE-Diabetes instruments into one self-administered questionnaire (118 items)
to assess (i) patients’ experiences with diabetes care provided by their general practitioner (GP),
internist, nurse, or dietician and (ii) their diabetes-specific health outcomes. Survey population diabetes patients of one insurer (Agis), enrolled in the sickness fund and aged 50 or above. Sample 983 patients who claimed reimbursement for diabetes medication in the 12 months prior to November 2003 were sent a questionnaire. Results: A total of 563 patients returned the questionnaire and confirmed being diabetic (response rate 63.5%). 510 diabetes patients completed the questionnaire. Non-response bias was unlikely. Filling out the questionnaire did not seem a problem for the majority of respondents. Psychometric properties of the questionnaire compared well with the two underlying pre-existing questionnaires. ‘Diabetes specific communication’ was a consistent 4-item factor in the new instrument, independent of the type of care provider. Internal consistency reliability was good (Cronbach’s alpha ranged 0.84–0.89). ‘Provider-patient interaction’ was a consistent 5-item factor for care by GP’s, internists and nurses (Cronbach’s alpha 0.89–0.92), but not dieticians. Respondents reported case management and outcome measures similar to those in other studies. Conclusions: The newly constructed—CAHPS and QUOTE-Diabetes based—questionnaire is reliable and valid and is well received by respondents. It offers a strong basis for further development of patient experiences survey for Diabetes Care in the Dutch healthcare context. (aut.ref.)