Development and psychometric evaluation of a measure to evaluate the quality of integrated care: the Patient Assessment of Integrated Elderly Care

Abstract

BackgroundNovel population‐based integrated care services are being developed to adequately serve the growing number of elderly people. Suitable, reliable and valid measurement instruments are needed to evaluate the quality of care delivered.ObjectiveTo develop a measure to evaluate the quality of integrated care from the perspective of elderly people, the Patient Assessment of Integrated Elderly Care (PAIEC), and then to assess its psychometric properties.Methods/DesignAfter the Patient Assessment of Chronic Illness Care was adapted to the PAIEC, a cross‐sectional postal‐survey study was performed among 223 elderly people who received integrated elderly care and support. We assessed the factor structure, internal consistency, known groups and divergent validity using robust nonparametric tests.ResultsMean age of participants was 83 years (standard deviation 4.7), and 69% was female. The original five‐factor model was rejected; a good fit was found for a three‐factor model, when excluding the item on patients' satisfaction with care. The PAIEC and its subscales showed good internal consistency (ordinal alphas > 0.90). Known‐groups validity was supported regarding number of medications, prevalence of chronic conditions and home care received. No differences were found between groups based on sociodemographic aspects. Divergent validity was supported by low correlations (Spearman's rank correlation coefficients < 0.30) between PAIEC scales and measures of quality of life, complexity of care needs and frailty.ConclusionThe PAIEC seems to have considerable potential as a reliable and valid measurement instrument that evaluates quality of integrated care and support from the perspective of elderly people.

Elderly with remaining teeth report less frailty and better quality of life than edentulous elderly: a cross‐sectional study

“…With regard to the Embrace participants, non‐respondents differed from respondents regarding gender (more women declined to participate, P < 0.05) and age (older participants consented less often, P = 0.01). For details, see Spoorenberg et al (, ) and Uittenbroek et al (,b). Of the oral health status questionnaires sent to the 1325 participants in Embrace, 1041 questionnaires were returned (response rate of 79%).…”

“…In case of missing data, elderly were interviewed via the telephone to complete the questionnaire. For more details about Embrace, the person‐centered, and integrated care service, see the studies of Spoorenberg et al (, ) and Uittenbroek et al (,b). Informed consent was obtained from all participants, and the study was performed in accordance with the Declaration of Helsinki.…”

The Partners in Health scale for older adults: design and examination of its psychometric properties in a Dutch population of older adults

“…Perceived integrated care was measured using the Dutch version of the Patient Assessment of Integrated Elderly Care (PAIEC) . The subscale “Patient activation and contextual information” contained seven items, the subscale “Goal setting and problem‐solving” seven items and the subscale “Coordination and follow‐up” six items.…”

“…Reliable and valid measurement instruments are needed to keep track of these self‐management abilities, behaviour and need for support of older adults. Such measurement instruments are not yet available for the self‐management behaviour of community‐living older adults, although they are for self‐management abilities and perceived self‐management support . A measurement instrument for self‐management behaviour is important to assess the status and to follow the development of someone's self‐management behaviour over time.…”

Self-management in older adults: how to delineate self-management ability, self-management behavior, and self-management support?

“…Self-management support (hereafter: "support") was assessed with the Patient Assessment of Integrated Elderly Care (PAIEC) [19]. The subscale "Patient activation and contextual information" (hereafter: "Patient activation") contains seven items, as does the subscale "Goal-setting and problem-solving" (hereafter: "Goal-setting").…”