Psychometric Evaluation of the Patient-Experienced Continuity of Care Questionnaire (PECQ) Using Rasch Model

The Patient-Experienced Continuity of care Questionnaire (PECQ) was developed to measure continuity of care (CoC) in primary care, but has only been evaluated in accordance with classical test theory, which has some weaknesses compared with modern test theory.

The aim of this study was to evaluate the measurement properties of the PECQ using the Rasch model.

Data for this psychometric study were collected using questionnaires administered to patients aged 18 years and older with one or more chronic conditions. Participants were consecutively recruited from 18 public primary care centres. The final sample comprised 324 patients (54% female and 46% male) with a mean age of 71.8 years (SD = 12).

The PECQ demonstrated satisfactory measurement properties in terms of individual item fit, response category functioning, targeting and differential item functioning by age. Minor issues were identified regarding global model fit, local independence, reliability and non-uniform differential item functioning by sex.

Overall, the results show that PECQ has sound psychometric properties in adult patients with chronic disease and can be used to measure CoC in primary care settings.

This study addresses the need for accurate measurement of patient experiences of CoC, and the Rasch model was therefore used to evaluate the PECQ. As the instrument demonstrated good fit to the Rasch model, the findings have important implications for healthcare researchers, policymakers and practitioners. The PECQ provides a scientifically sound tool for evaluating CoC, enabling more accurate quality assessments and supporting targeted interventions in both Swedish and international primary care contexts where the instrument is adapted.

Patients were actively involved in the study by participating in the cognitive validation of the questionnaire items. Their contributions helped ensure that the content was understandable, relevant and appropriately tailored to the target population. By providing feedback on the wording and content, the patients contributed to the development of a user-friendly and contextually grounded instrument, which was subsequently validated in this study using the Rasch model.