Pay-for-performance has become increasingly common to complement physician reimbursement. We designed a quality framework to measure family physicians' performance in a managed care setting in Buenos Aires. We aimed to assess the effectiveness of a multimodal intervention based on pay-for-performance, teamwork, continuous education, and audit and feedback to improve quality. After 2 years, a significant improvement was observed in most of the indicators measuring clinical effectiveness and some improvements were observed in other domains. Despite these results, a better performance matrix is needed to capture not only specific conditions but also other aspects like integrating, prioritizing, and personalizing care.
Objective
To translate, transcultural adapt, and validate the “CollaboRATE” measure and the “Ask 3 Questions” intervention in Argentina, allowing us to quantify the degree of use and implementation of shared decision making (SDM).
Design
Cross‐sectional study.
Setting and Participants
Data were collected in an academic hospital in Buenos Aires. Physician–patient pairs were invited to participate following their scheduled outpatient visits.
Measurements
Two processes were carried out as follows: (a) The translation and transcultural adaptation process, in which translations were produced and then adapted to Spanish. (b) The validation process, in which questionnaires were completed by patient–physician pairs, the results of which were subsequently analysed. Reliability (Cronbach's alpha) and construct validity (principal component analysis) were assessed.
Results
The final Spanish versions of “CollaboRATE” and “Ask 3 Questions” were tested in a primary care sample of 56 participants. Both instruments presented adequate reliability and validity. Internal consistency yielded a Cronbach's alpha of 98.3 for the “CollaboRATE” measure and 0.77 and 0.69 for the patients and physicians versions of the “Ask 3 Questions” intervention. Principal components analysis showed eigenvalues of first component >1.
Discussion and Conclusions
We obtained valid and reliable Spanish versions of the “CollaboRATE” measure and the “Ask 3 Questions” intervention. These versions can be used for the assessment of SDM in clinical visits, and to obtain new information which could help the monitoring of its implementation.
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