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Quality of needs assessment for care and assistive devices from a client's perspective.
Nispen, R.M.A. van, Sixma, H.J., Kerkstra, A. Quality of needs assessment for care and assistive devices from a client's perspective. European Journal of Public Health: 2002, 12(suppl. 4) Abstract of the 10th Annual Eupha Meeting 'Bridging the gap between research and policy in public health' in Dresden, Germany 28 - 30 november 2002.
Background: Like in many other European countries, health care policy makers in The Netherlands are looking for new ways to organize different health care services. To facilitate a more objective, independent and integral assessment for individuals in need of (nursing) home care or assistive devices, the Dutch government introduced 85 Regional Individual Needs Assessment Agencies (RIOs). The introduction process in 1998 didn't go smoothly. RIOs were criticized for bureaucracy, waiting lists and other problems related to the assessment procedures. Aim: The aim of the study was to develop an instrument to measure the quality of needs assessment by RIOs from a client's perspective. Methods: A combination of qualitative and quantitative methods was used. All data were collected in november 2001. Almost 400 quality aspects covering different phases of the needs assessment process were derived from interviews with key-figures and five focus-group discussions with (representatives of) patients. 68 aspects were included in the quantitative part of the development study. Questionnaires were sent to 2940 clients of four RIOs (response rate 55%). Results: The process of item selection and scale optimization, based on PCA and reliability analyses, resulted in 10 quality-dimensions, with alpha-coefficients between .64 and .88. Professional competence and courtesy during assessment received the highest importance scores (7.7 on 1-10 scale). Important areas for quality improvement were telephone applications for assessment, the final assessment-advice and information. Importance ratings were combined with performance scores into quality improvement indices. Conclusions: The instrument proved to be reliable, valid and useful for RIO-clients with a demand for (nursing) home care and assistive devices. RIOs participating in the development study adopted the results as part of their total quality management process. The measurement instrument can be used in future national representative benchmark studies or in evaluative studies on quality improvement. (aut. ref.)
Background: Like in many other European countries, health care policy makers in The Netherlands are looking for new ways to organize different health care services. To facilitate a more objective, independent and integral assessment for individuals in need of (nursing) home care or assistive devices, the Dutch government introduced 85 Regional Individual Needs Assessment Agencies (RIOs). The introduction process in 1998 didn't go smoothly. RIOs were criticized for bureaucracy, waiting lists and other problems related to the assessment procedures. Aim: The aim of the study was to develop an instrument to measure the quality of needs assessment by RIOs from a client's perspective. Methods: A combination of qualitative and quantitative methods was used. All data were collected in november 2001. Almost 400 quality aspects covering different phases of the needs assessment process were derived from interviews with key-figures and five focus-group discussions with (representatives of) patients. 68 aspects were included in the quantitative part of the development study. Questionnaires were sent to 2940 clients of four RIOs (response rate 55%). Results: The process of item selection and scale optimization, based on PCA and reliability analyses, resulted in 10 quality-dimensions, with alpha-coefficients between .64 and .88. Professional competence and courtesy during assessment received the highest importance scores (7.7 on 1-10 scale). Important areas for quality improvement were telephone applications for assessment, the final assessment-advice and information. Importance ratings were combined with performance scores into quality improvement indices. Conclusions: The instrument proved to be reliable, valid and useful for RIO-clients with a demand for (nursing) home care and assistive devices. RIOs participating in the development study adopted the results as part of their total quality management process. The measurement instrument can be used in future national representative benchmark studies or in evaluative studies on quality improvement. (aut. ref.)