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[Design and validation of a complex case evaluation index].

M L Ruiz-Miralles1, M Richart-Martínez, S García-Sanjuán

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Summary

The Complex Case Assessment Index (CCAI) is a reliable and valid tool for identifying patients with complex health needs. This fast, easy-to-use index aids in screening and managing complex patient populations effectively.

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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.