[Design and validation of a complex case evaluation index]

Area of Science:

• Healthcare Management
• Patient Assessment Tools
• Health Services Research

Background:

• Developing a specific instrument to identify complex patients is crucial for targeted healthcare interventions.
• Existing methods may not adequately capture the multifaceted nature of patient complexity.
• The Complex Case Assessment Index (CCAI) was conceptualized to address this gap.

Purpose of the Study:

• To develop and validate the Complex Case Assessment Index (CCAI).
• To create a specific instrument for identifying patients with complex needs.
• To ensure the index is reliable and valid for clinical use.

Main Methods:

• Instrumental study in two phases: scale development and psychometric evaluation.
• Scale development involved defining and operationalizing variables, followed by expert judgment.
• Psychometric evaluation included inter-observer reliability, criterion validity (vs. CRG), and construct validity (known groups, cluster analysis).

Main Results:

• The CCAI demonstrated good reliability: r=0.97 (clinical), r=0.74 (community), r=0.89 (total).
• The CCAI identified 518 complex cases, with 88.4% aligning with high clinical complexity (CRG levels 6-9).
• Results supported the scale's construct validity, with cluster analysis revealing distinct patient groups.

Conclusions:

• The CCAI is a fast, user-friendly index with strong conceptual adequacy.
• The index provides evidence of reliability and validity for screening patients with complex needs.
• CCAI facilitates efficient identification of patients requiring specialized care management.