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BMC Health Services Research
Published in: BMC Health Services Research 1/2007

Open Access 01-12-2007 | Research article

The Consumer Quality Index Hip Knee Questionnaire measuring patients' experiences with quality of care after a total hip or knee arthroplasty

Authors: Janine H Stubbe, Tanya Gelsema, Diana MJ Delnoij

Published in: BMC Health Services Research | Issue 1/2007

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Abstract

Background

The Dutch Consumer Quality Index Hip Knee Questionnaire (CQI Hip Knee) was used to assess patients' experiences with and evaluations of quality of care after a total hip (THA) or total knee arthroplasty (TKA). The aim of this study is to evaluate the construct validity and internal consistency reliability of this new instrument and to assess its ability to measure differences in quality of care between hospitals.

Methods

Survey data of 1,675 subjects who underwent a THA or TKA were used to evaluate the psychometric properties. Exploratory factor analyses were performed and item-total correlations and inter-factor correlations were calculated to assess the construct validity of the instrument. Reliability analyses included tests of internal consistency (Cronbach's alpha coefficients). Finally, multilevel analyses were performed to assess the ability of the instrument to discriminate between hospitals in quality of care.

Results

Exploratory factor analyses indicated that the survey consisted of 21 items measuring five aspects of care (i.e. communication with nurses, communication with doctors, communication with general practitioner, communication about new medication, and pain control). Cronbach's alpha coefficients ranged from 0.76 to 0.90 indicating good internal consistency. The survey's ability to discriminate between hospitals was partly supported by multilevel analysis. Two scales (i.e. communication with nurses and communication with doctors) were able to measure differences between hospitals with respect to patients' experiences with quality of care. Logistic multilevel analyses indicated that hospitals explained part of the variation between patients in receiving information.

Conclusion

These findings suggest that the CQI Hip Knee is reliable and valid for use in Dutch health care. Health care providers or health plans can use this survey to measure patients' experiences with hospital care and to identify variations in care between hospitals.
Literature
1.
Zuurbier J, van Gerven E: DBC's als middel om de diffusie van verbeterde werkwijzen in de zorg te versnellen. Weten wat we doen: Verspreiding en innovaties in de zorg. Edited by: Schrijvers AJP, Jeurissen PPT, Ottes L, Blank JLT, van Hulst BL, Zuurbier J, et al. 2006, Zoetermeer: Raad voor de Volksgezondheid en Zorg, 163-191.
2.
Hibbard JH, Harris-Kojetin L, Mullin P, Lubalin J, Garfinkel S: Increasing the impact of health plan report card by adressing consumers' concerns. Health Aff. 2000, 19: 138-143. 10.1377/hlthaff.19.5.138.CrossRef
3.
Iezzoni LI: Toward universal design in assessing health care experiences. Med Care. 2002, 40: 725-728. 10.1097/00005650-200209000-00001.PubMedCrossRef
4.
Jenkinson C: Assessment and Evaluation of Health and Medical Care. 1997, Buckingham: University Press
5.
Cleary PD, Edgman-Levitan S: Health care quality: Incorporating consumer perspectives. JAMA. 1997, 278: 1608-1612. 10.1001/jama.278.19.1608.PubMedCrossRef
6.
Cleary PD, Edgman-Levitan S, Roberts M: Patients evaluate their hospital care: a national survey. Health Aff (Millwood). 1991, 10: 254-267. 10.1377/hlthaff.10.4.254.CrossRef
7.
Hekkink CF, Sixma HJ, Wigersma L, Yzermans CJ, Van Der Meer JT, Bindels PJ, Brinkman K, Danner SA: QUOTE-HIV: an instrument for assessing quality of HIV care from the patients' perspective. Qual Saf Health Care. 2003, 12: 188-193. 10.1136/qhc.12.3.188.PubMedPubMedCentralCrossRef
8.
Nijkamp MD, Sixma HJ, Afman H, Hiddema F, Koopmans SA, van den BB, Hendrikse F, Nuijts RM: Quality of care from the perspective of the cataract patient: the reliability and validity of the QUOTE-cataract. Br J Ophthalmol. 2002, 86: 840-842. 10.1136/bjo.86.8.840.PubMedPubMedCentralCrossRef
9.
Nijkamp MD, Sixma HJ, Afman H, Hiddema F, Koopmans SA, van den BB, Hendrikse F, Nuijts RM: Quality of care from the perspective of the cataract patient. QUOTE cataract questionnaire. J Cataract Refract Surg. 2002, 28: 1924-1931. 10.1016/S0886-3350(02)01373-1.PubMedCrossRef
10.
Sixma HJ, van Campen C, Kerssens JJ, Peters L: Quality of care from the perspective of elderly people: the QUOTE-elderly instrument. Age Ageing. 2000, 29: 173-178. 10.1093/ageing/29.2.173.PubMedCrossRef
11.
van Campen C, Sixma HJ, Kerssens JJ, Peters L: Assessing non institutionalized asthma and COPD patients' priorities and perceptions of quality of health care: the development of the QUOTE-CNSLD instrument. J Asthma. 1997, 34: 531-538.PubMedCrossRef
12.
van Campen C, Sixma HJ, Kerssens JJ, Peters L, Rasker JJ: Assessing patients' priorities and perceptions of the quality of health care: the development of the QUOTE-Rheumatic-Patients instrument. Br J Rheumatol. 1998, 37: 362-368. 10.1093/rheumatology/37.4.362.PubMedCrossRef
13.
van der Eijk I, Sixma H, Smeets T, Veloso FT, Odes S, Montague S, Fornaciari G, Moum B, Stockbrugger R, Russel M: Quality of health care in inflammatory bowel disease: development of a reliable questionnaire (QUOTE-IBD) and first results. Am J Gastroenterol. 2001, 96: 3329-3336.PubMedCrossRef
14.
Farley DO, Short PF, Elliott MN, Kanouse DE, Brown JA, Hays RD: Effects of CAHPS health plan performance information on plan choices by New Jersey Medicaid beneficiaries. Health Serv Res. 2002, 37: 985-1007. 10.1034/j.1600-0560.2002.62.x.PubMedPubMedCentralCrossRef
15.
Goldstein E, Fyock J: Reporting of CAHPS quality information to medicare beneficiaries. Health Serv Res. 2001, 36: 477-488.PubMedPubMedCentral
16.
Hargraves JL, Hays RD, Cleary PD: Psychometric properties of the Consumer Assessment of Health Plans Study (CAHPS) 2.0 adult core survey. Health Serv Res. 2003, 38: 1509-1527. 10.1111/j.1475-6773.2003.00190.x.PubMedCrossRef
17.
Hays RD, Shaul JA, Williams VS, Lubalin JS, Harris-Kojetin LD, Sweeny SF, Cleary PD: Psychometric properties of the CAHPS 1.0 survey measures. Consumer Assessment of Health Plans Study. Med Care. 1999, 37: MS22-MS31. 10.1097/00005650-199903001-00003.PubMedCrossRef
18.
Morales LS, Elliott MN, Weech-Maldonado R, Spritzer KL, Hays RD: Differences in CAHPS adult survey reports and ratings by race and ethnicity: an analysis of the National CAHPS benchmarking data 1.0. Health Serv Res. 2001, 36: 595-617.PubMedPubMedCentral
19.
Solomon LS, Hays RD, Zaslavsky AM, Ding L, Cleary PD: Psychometric properties of a group-level Consumer Assessment of Health Plans Study (CAHPS) instrument. Med Care. 2005, 43: 53-60.PubMed
20.
Spranca M, Kanouse DE, Elliott M, Short PF, Farley DO, Hays RD: Do consumer reports of health plan quality affect health plan selection?. Health Serv Res. 2000, 35: 933-947.PubMedPubMedCentral
21.
Brouwer W, Sixma HJ, Triemstra M, Delnoij DM: Kwaliteit van zorg rondom een staaroperatie vanuit het perspectief van patiënten: meetinstrumentontwikkeling. 2006, Utrecht: NIVEL
22.
Arah OA, ten Asbroek AH, Delnoij DM, de Koning JS, Stam PJ, Poll AH, Vriens B, Schmidt PF, Klazinga NS: Psychometric properties of the Dutch version of the Hospital-level Consumer Assessment of Health Plans Survey instrument. Health Serv Res. 2006, 41: 284-301. 10.1111/j.1475-6773.2005.00462.x.PubMedPubMedCentralCrossRef
23.
Hall JA, Dornan MC: Patient sociodemographic characteristics as predictors of satisfaction with medical care: a meta-analysis. Soc Sci Med. 1990, 30: 811-818. 10.1016/0277-9536(90)90205-7.PubMedCrossRef
24.
Nguyen Thi PL, Braincon S, Empereur F, Guillemin F: Factors determining inpatient satisfaction with care. Soc Sci Med. 2007, 54: 493-504. 10.1016/S0277-9536(01)00045-4.CrossRef
25.
Pascoe GC, Attkisson CC: The evaluation ranking scale: a new methodology for assessing satisfaction. Eval Program Plann. 1983, 6: 335-347. 10.1016/0149-7189(83)90013-7.PubMedCrossRef
26.
Williams SJ, Calnan M: Convergence and divergence: assessing criteria of consumer satisfaction across general practice, dental and hospital care settings. Soc Sci Med. 1991, 33: 707-716. 10.1016/0277-9536(91)90025-8.PubMedCrossRef
27.
Sixma HJ, van Campen C, Kerssens JJ, Peters L: Quality of Care from the patients' perspective: from theoretical concept to a new measuring instrument. Health Expect. 1998, 1: 82-95. 10.1046/j.1369-6513.1998.00004.x.PubMedPubMedCentralCrossRef
28.
Gelsema T, Delnoij DM, Triemstra M: Kwaliteit van zorg rondom een totale heup- of knieoperatie vanuit het perspectief van consumentenpatiënten: meetinstrumentenontwikkeling en validatie. 2006
29.
Floyd FJ, Widaman KF: Factor analysis in the development and refinement of clinical assessment instruments. Psychol Assess. 1995, 7: 286-299. 10.1037/1040-3590.7.3.286.CrossRef
30.
Muthen BO: Dichotomous factor analysis of symptom data. Soc Methods Res. 1989, 18: 19-65. 10.1177/0049124189018001002.CrossRef
31.
Waller NG, Tellegen A, McDonals RP, Lykken DT: Exploring non-linear models in personality assessments: development and preliminary validation of a negative emotionality scale. J Pers. 1996, 64: 545-576. 10.1111/j.1467-6494.1996.tb00521.x.CrossRef
32.
Kaiser HF: The application of electronic computers to factor analysis. Educ Psychol Meas. 1960, 20: 141-151. 10.1177/001316446002000116.CrossRef
33.
Cattell RB: The scree test for the number of factors. Multivariate Behav Res. 1966, 1: 245-276. 10.1207/s15327906mbr0102_10.PubMedCrossRef
34.
Howard KI, Forehand GC: A method for correcting item-total correlations for the effect of relevant item inclusion. Educ Psychol Meas. 1962, 22: 731-735. 10.1177/001316446202200407.CrossRef
35.
Nunnally JC, Bernstein IH: Psychometric Theory. 1978, New York: McGraw-Hill
36.
Carey RG, Seibert JH: A patient survey system to measure quality improvement: questionnaire reliability and validity. Med Care. 1993, 31: 834-845.PubMedCrossRef
37.
Cronbach JL: Coefficient alpha and the internal structure of tests. Psychometrika. 1951, 16: 297-334. 10.1007/BF02310555.CrossRef
38.
Kuder GF, Richardson MW: The theory of the estimation of test reliability. Psychometrika. 1937, 2: 151-160. 10.1007/BF02288391.CrossRef
39.
Rasbash J, Steele F, Browne W, Prosser B: A user's guide to MLwiN version 2.0. 2004, London: Institute of Education, University of London
40.
Hox JJ: Applied Multilevel Analysis. 1995, Amsterdam
41.
Merlo J, Chaix B, Yang M, Lynch J, Rastam L: A brief conceptual tutorial of multilevel analysis in social epidemiology: linking the statistical concept of clustering to the idea of contextual phenomenon. J Epidemiol Community Health. 2005, 59: 443-449. 10.1136/jech.2004.023473.PubMedPubMedCentralCrossRef
42.
Merlo J, Yang M, Chaix B, Lynch J, Rastam L: A brief conceptual tutorial on multilevel analysis in social epidemiology: investigating contextual phenomena in different groups of people. J Epidemiol Community Health. 2007, 59: 729-736. 10.1136/jech.2004.023929.CrossRef
43.
Harris IB, Rich EC, Crowson TW: Attitudes of internal medicine residents and staff physicians toward various patient characteristics. J Med Educ. 1985, 60: 192-195.PubMed
44.
Street RL, Buller DB: Patients' characteristics affecting physician-patient nonverbal communication. Hum Commun Res. 1988, 15: 60-90. 10.1111/j.1468-2958.1988.tb00171.x.CrossRef
45.
Adams G, Gulliford MC, Ukoumunne OC, Eldridge S, Chinn S, Campbell MJ: Patterns of intra-cluster correlation from primary care research to inform study design and analysis. J Clin Epidemiol. 2004, 57: 785-794. 10.1016/j.jclinepi.2003.12.013.PubMedCrossRef
46.
Tang J, Gibson SJ: A psychophysical evaluation of the relationship between trait anxiety, pain perception, and induced state anxiety. J Pain. 2005, 6 (9): 612-619. 10.1016/j.jpain.2005.03.009.PubMedCrossRef
Metadata
Title
The Consumer Quality Index Hip Knee Questionnaire measuring patients' experiences with quality of care after a total hip or knee arthroplasty
Authors
Janine H Stubbe
Tanya Gelsema
Diana MJ Delnoij
Publication date
01-12-2007
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2007
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-7-60

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