Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Primary Care
Published in: BMC Primary Care 1/2008

Open Access 01-12-2008 | Research article

The General Practice Assessment Questionnaire (GPAQ) – Development and psychometric characteristics

Authors: Nicola Mead, Peter Bower, Martin Roland

Published in: BMC Primary Care | Issue 1/2008

Login to get access

Abstract

Background

Continual quality improvement in primary care is an international priority. In the United Kingdom, the major initiative for improving quality of care is the Quality and Outcomes Framework (QoF) of the 2004 GP contract. Although the primary focus of the QoF is on clinical care, it is acknowledged that a comprehensive assessment of quality also requires valid and reliable measurement of the patient perspective, so financial incentives are included in the contract for general practices to survey patients' views. One questionnaire specified for use in the QoF is the General Practice Assessment Questionnaire (GPAQ). This paper describes the development of the GPAQ (with post-consultation and postal versions) and presents a preliminary examination of the psychometric properties of the questionnaire.

Methods

Description of scale development and preliminary analysis of psychometric characteristics (internal reliability, factor structure), based on a large dataset of routinely collected GPAQ surveys (n = 190,038 responses to the consultation version of GPAQ and 20,309 responses to the postal version) from practices in the United Kingdom during the 2005–6 contract year.

Results

Respondents tend to report generally favourable ratings. Responses were particularly skewed on the GP communication scale, though no more so than for other questionnaires in current use in the UK for which data were available. Factor analysis identified 2 factors that clearly relate to core concepts in primary care quality ('access' and 'interpersonal care') that were common to both version of the GPAQ. The other factors related to 'enablement' in the post-consultation version and 'nursing care' in the postal version.

Conclusion

This preliminary evaluation indicates that the scales of the GPAQ are internally reliable and that the items demonstrate an interpretable factor structure. Issues concerning the distributions of GPAQ responses are discussed. Potential further developments of the item content for the GPAQ are also outlined.
Appendix
Available only for authorised users
Literature
1.
Roland M: Linking physicians' pay to the quality of care. A major experiment in the United Kingdom. N Engl J Med. 2004, 351: 1448-1454. 10.1056/NEJMhpr041294.CrossRefPubMed
2.
3.
Coulter A, Elwyn G: What do patients want from high quality general practice and how do we involve them in improvement?. Br J Gen Pract. 2002, 52 (Suppl): S22-S26.
4.
Bower P: Measuring patients' asessments of primary care quality: the use of self-report questionnaires. Expert Review of Pharmacoeconomics and Outcomes Research. 2003, 3: 551-560. 10.1586/14737167.3.5.551.CrossRefPubMed
5.
Baker R: DIALOGUE 3rd Edition - a method for surveying patient satisfaction - manual for users. 2001, University of Leicester, Department of General Practice and Primary Health Care
6.
Baker R: Development of a questionnaire to assess patients' satisfaction with consultations in general practice. Br J Gen Pract. 1990, 40: 487-490.PubMedPubMedCentral
7.
Carter M, Roland M, Bower P, Greco M, Jenner D: Improving your practice with patient surveys. 2004, University of Manchester, NPCRDC/CFEP
8.
Greco M, Carter M: Improving Practice Questionnaire (IPQ) Tool Kit. 2002, Chichester, Aeneas
9.
10.
11.
Ramsay J, Campbell J, Schroter S, Green J, Roland M: The General Practice Assessment Survey (GPAS): tests of data quality and measurement properties. Fam Pract. 2000, 17: 372-379. 10.1093/fampra/17.5.372.CrossRefPubMed
12.
Taira D, Gelb Safran D, Seto B, Rogers W, Inui T, Montgomery J, Tarlov A: Do patient assessments of primary care differ by patient ethnicity?. Health Serv Res. 2001, 36: 1059-1071.PubMedPubMedCentral
13.
Gelb Safran D, Tarlov A, Rogers W: Primary care performance in fee-for-service and prepaid health care systems: results from the medical outcome study. JAMA. 1994, 271: 1579-1586. 10.1001/jama.271.20.1579.CrossRef
14.
Gelb Safran D, Rogers W, Tarlov A, Inui T, Taira A, Montgomery J, Ware J, Slavin C: Organizational and financial characteristics of health plans: are they related to primary care performance?. Arch Intern Med. 2000, 160: 69-76. 10.1001/archinte.160.1.69.CrossRef
15.
Murray A, Gelb Safran D, Rogers W, Inui T, Chang H, Montgomery J: Part-time physicians: physician workload and patient-based assessment of primary care performance. Arch Fam Med. 2000, 9: 327-332. 10.1001/archfami.9.4.327.CrossRefPubMed
16.
Gelb Safran D, Taira D, Rogers W, Kosinski M, Ware J, Tarlov A: Linking primary care performance to outcomes of care. J Fam Pract. 1998, 47: 213-220.
17.
Gelb Safran D, Montgomery J, Chang H, Murphy J, Rogers W: Switching doctors: predictors of voluntary disenrollment for a primary physician's practice. J Fam Pract. 2001, 50: 130-136.
18.
Bower P, Mead N, Roland M: What dimensions underlie patient responses to the General Practice Assessment Survey? A factor analytic study. Fam Pract. 2002, 19: 489-495. 10.1093/fampra/19.5.489.CrossRefPubMed
19.
Campbell J, Ramsay J, Green J: Age, gender, socioeconomic, and ethnic differences in patients' assessments of primary health care. Quality in Health Care. 2001, 10: 90-95. 10.1136/qhc.10.2.90.CrossRefPubMedPubMedCentral
20.
Bower P, Roland M, Campbell J, Mead N: Setting standards based on patients' views on access and continuity: secondary analysis of data from the general practice assessment survey. BMJ. 2003, 326: 258-10.1136/bmj.326.7383.258.CrossRefPubMedPubMedCentral
21.
Campbell J, Ramsay J, Green J: Practice size: impact on consultation length, workload, and patient assessment of care. Br J Gen Pract. 2001, 51: 644-650.PubMedPubMedCentral
22.
Campbell S, Hann M, Hacker J, Burns C, Oliver D, Thapar A, Mead N, Gelb Safran D, Roland M: Identifying predictors of high quality care in English general practice: observational study. BMJ. 2001, 323: 784-787. 10.1136/bmj.323.7316.784.CrossRefPubMedPubMedCentral
23.
Bower P, Campbell S, Bojke C, Sibbald B: Team structure, team climate and the quality of care in primary care: an observational study. Qual Saf Health Care. 2003, 12: 273-279. 10.1136/qhc.12.4.273.CrossRefPubMedPubMedCentral
24.
Alazri M, Neal R: The association between satisfaction with services provided in primary care and outcomes in Type 2 diabetes mellitus. Diabetic Medicine. 2003, 20: 486-490. 10.1046/j.1464-5491.2003.00957.x.CrossRefPubMed
25.
Hankins M, Fraser A, Hodson A, Hooley C, Smith H: Measuring patient satisfaction for the Quality and Outcomes Framework. Br J Gen Pract. 2007, 57: 737-740. 10.3399/096016407782604956.CrossRefPubMedPubMedCentral
26.
Howie J, Heaney D, Maxwell M, Walker J: A comparison of Patient Enablement Instrument (PEI) against two established satisfaction scales as an outcome measure of primary care consultations. Fam Pract. 1998, 15: 165-171. 10.1093/fampra/15.2.165.CrossRefPubMed
27.
Howie J, Heaney D, Maxwell M, Walker J, Freeman G: Developing a 'consultation quality index' (CQI) for use in general practice. Fam Pract. 2000, 17: 455-461. 10.1093/fampra/17.6.455.CrossRefPubMed
28.
Secretary of State for Health: The NHS Plan. 2000, London, HMSO
29.
Rickards L, Fox K, Roberts C, Fletcher L, Goddard E: Living in Britain: results form the 2002 General Household Survey. 2004, London, The Stationery Office
30.
31.
Tabachnick B, Fidell L: Using Multivariate Statistics. 2001, Boston, Allyn and Bacon, 4
32.
Kline P: An Easy Guide to Factor Analysis. 1994, London, Routledge
33.
McKinstry B, Colthart I, Walker J: Can doctors predict patients' satisfaction and enablement? A cross-sectional observational study. Fam Pract. 2006, 23: 240-245. 10.1093/fampra/cmi111.CrossRefPubMed
34.
Collins K, O'Cathain A: The continuum of patient satisfaction - from satisfied to very satisfied. Soc Sci Med. 2003, 57: 2465-2470. 10.1016/S0277-9536(03)00098-4.CrossRefPubMed
35.
Health Commission: Survey of Patients 2005 Primary Care Trust. 2005, London, Healthcare Commission
36.
Greco M, Jenner D, Powell R: Evaluation of Patient Experience Based on Three Cycles of QOF Surveys using the Improving Practice Questionnaire (IPQ). 2007, Exeter, CFEP UK Surveys
37.
McGuiness C, Sibthorpe B: Development and initial validation of a measure of coordination of health care. International Journal for Quality in Health Care. 2003, 15: 309-318. 10.1093/intqhc/mzg043.CrossRefPubMed
38.
Department of Health: The Expert Patient: a new approach to chronic disease management for the 21st Century. 2001, HMSO, Department of Health
39.
Donaldson L: Expert patients usher in a new era of opportunity for the NHS. BMJ. 2004, 326: 1279-10.1136/bmj.326.7402.1279.CrossRef
40.
Blakeman T, MacDonald W, Bower P, Gately C, Chew-Graham C: A qualitative study of GPs' attitudes to self-management of chronic disease. Br J Gen Pract. 2006, 56: 407-414.PubMedPubMedCentral
41.
42.
Greco M, Brownlea A, McGovern J: Impact of patient feedback on the interpersonal skills of general practice registrars: results of a longitudinal study. Med Educ. 2001, 35: 748-756. 10.1046/j.1365-2923.2001.00976.x.CrossRefPubMed
43.
Vingerhoets E, Wensing M, Grol R: Feedback of patients' evaluations of general practice care: a randomised trial. Quality in Health Care. 2001, 10: 224-228. 10.1136/qhc.0100224...CrossRefPubMedPubMedCentral
44.
Streiner D, Norman G: Health Measurement Scales - a practical guide to their development and use. 1989, Oxford, Oxford Medical Publications, 1
Metadata
Title
The General Practice Assessment Questionnaire (GPAQ) – Development and psychometric characteristics
Authors
Nicola Mead
Peter Bower
Martin Roland
Publication date
01-12-2008
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2008
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-9-13

Other articles of this Issue 1/2008

BMC Primary Care 1/2008 Go to the issue

Study protocol

Randomized double-blind placebo-controlled trial of sublingual immunotherapy in children with house dust mite allergy in primary care: study design and recruitment

Research article

Three years follow-up of screen-detected diabetic and non-diabetic subjects: who is better off? The ADDITION Netherlands study

Research article

Determining patient and primary care delay in the diagnosis of cancer – lessons from a pilot study of patients referred for suspected cancer

Research article

Models in the delivery of depression care: A systematic review of randomised and controlled intervention trials

Research article

Differences in referral rates to specialised health care from four primary health care models in Klaipeda, Lithuania

Research article

Acceptability and effectiveness of opportunistic referral of smokers to telephone cessation advice from a nurse: a randomised trial in Australian general practice