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['Consumer quality'-index 'General practice care' measures patients' experiences and compares general practices with
Liesbeth E Meuwissen1, Dinny H de Bakker
1Nederlands instituut voor onderzoek van de gezondheidszorg (NIVEL), Utrecht, The Netherlands. liesbethmeuwissen@yahoo.com
Objective:
To develop a method to evaluate patients' experiences with general practice care in a scientifically sound manner and to enable comparisons to be made between general practices: the 'Consumer quality'(CQ)-index 'General practice care'.
Design:
Cross-sectional observational research.
Method:
Through the use of questionnaires the CQ-index asks patients about their experiences with, and the importance they attach to, the different aspects of care provided in general practice by general practitioners, assistants, and other healthcare providers. The CQ-index was based on existing questionnaires and focus group discussions, and consists of a questionnaire concerning experiences and one concerning the importance of those experiences. These were distributed in a random sample among 400 and 100 patients respectively per practice in 32 participating general practices in Rotterdam and Drenthe, the Netherlands. The questionnaire was validated with the help of explorative factor analysis, reliability analysis and multilevel analysis.
Results:
The net response to the experiences' questionnaire was 47.6 %. The validated questionnaire contained 8 significant scales, with Cronbach's alpha of at least 0.70. There appeared to be considerable differences between practices. The biggest differences concerned accessibility and availability, a serious bottleneck in many practices. On most scales 100 respondents were sufficient to establish statistically significant differences between practices, when corrected for age, gender, educational level and health status. On the whole, assessment of general practice care was positive, as shown by an average score of 8.1 given to the practices, on a scale of 0-10. Participating general practitioners recognised their practices in the results.
Conclusion:
With the CQ-index 'General practice care' a valid instrument has been introduced, suitable for evaluating patient's experiences and for comparing general practices with each other.
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