The consumer quality index anthroposophic healthcare: a construction and validation study

BMC Health Services Research

Erik W Baars²  Diana MJ Delnoij¹  Rachel Heybroek²  Rob RS Ong²  Evi B Koster² 

[1] Scientific Centre for Transformation in Care and Welfare (Tranzo), Tilburg University, Tilburg, The Netherlands;Professorship Anthroposophic Healthcare, University of Applied Sciences Leiden, Zernikedreef 11, Leiden 2333 CK, The Netherlands

关键词: Patient-centered care;    Discriminating ability;    Psychometric quality;    Validation of measuring instrument;    Anthroposophic healthcare;    CQ-index;    Patient experiences;    Quality of care;   

Others  :  1133019
DOI  :  10.1186/1472-6963-14-148

 received in 2013-05-15, accepted in 2014-03-25,  发布年份 2014

【 摘 要 】

Background

Accounting for the patients’ perspective on quality of care has become increasingly important in the development of Evidence Based Medicine as well as in governmental policies. In the Netherlands the Consumer Quality (CQ) Index has been developed to measure the quality of care from the patients’ perspective in different healthcare sectors in a standardized manner. Although the scientific accountability of anthroposophic healthcare as a form of integrative medicine is growing, patient experiences with anthroposophic healthcare have not been measured systematically. In addition, the specific anthroposophic aspects are not measured by means of existing CQ Indexes. To enable accountability of quality of the anthroposophic healthcare from the patients’ perspective the aim of this study is the construction and validation of a CQ Index for anthroposophic healthcare.

Method

Construction in three phases: Phase 1. Determining anthroposophic quality aspects: literature study and focus groups. Phase 2. Adding new questions and validating the new questionnaire. Research population: random sample from 7910 patients of 22 anthroposophic GPs. Data collection: survey, mixed mode by means of the Dillman method. Measuring instrument: experience questionnaire: CQ Index General Practice (56 items), added with 27 new anthroposophic items added and an item-importance questionnaire (anthroposophic items only). Statistical analyses: Factor analysis, scale construction, internal consistency (Chronbach’s Alpha), inter-item-correlation, discriminative ability (Intra Class Correlation) and inter-factor-correlations. Phase 3. Modulation and selection of new questions based on results. Criteria of retaining items: general: a limited amount of items, statistical: part of a reliable scale and inter-item-correlation <0,7, and theoretical.

Results

Phase 1. 27 anthroposophic items. Phase 2. Two new anthroposophic scales: Scale AntroposophicTreatmentGP: seven items, Alpha=0,832, ICC=4,2 Inter-factor-correlation with existing GP-scales range from r=0,24 (Accessibility) to r=0,56 (TailoredCare). Scale InteractionalStyleGP: five items, Alpha=0,810, ICC=5,8, Inter-factor-correlation with existing GP-scales range from r=0,32 (Accessibility) to r=0,76 (TailoredCare). Inter-factor-correlation between new scales: r=0,50. Phase 3: Adding both scales and four single items. Removing eleven items and reformulating two items.

Conclusion

The CQ Index Anthroposophic Healthcare measures patient experiences with anthroposophic GP’s validly and reliably. Regarding the inter-factor-correlations anthroposophic quality aspects from the patients’ perspective are mostly associated with individually tailored care and patient centeredness.

【 授权许可】

   
2014 Koster et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 2.

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