Validity and reliability of the Patient Centred Assessment Method for patient complexity and relationship with hospital length of stay: a prospective cohort study

Abstract

ObjectivesSeveral instruments for evaluating patient complexity have been developed from a biopsychosocial perspective. Although relationships between the results obtained by these instruments and the length of stay in hospital have been examined, many instruments are complicated and not easy to use. The Patient Centred Assessment Method (PCAM) is a candidate for practical use. This study aimed to test the validity and reliability of the PCAM and examine the correlations between length of hospital stay and PCAM scores in a regional secondary care hospital in Japan.DesignProspective cohort study.Participants and settingTwo hundred and one patients admitted to Ouji Coop Hospital between July 2014 and September 2014.Main predictorPCAM total score in initial phase of hospital admission.Main outcomeLength of stay in hospital.ResultsAmong 201 patients (Female/Male=98/103) with mean (SD) age of 77.4±11.9 years, the mean PCAM score was 25±7.3 and mean (SD) length of stay in hospital (LOS) 34.1±40.9 days. Using exploratory factor analysis to examine construct validity, PCAM evidently has a two-factor structure, comprising medicine-oriented and patient-oriented complexity. The Spearman rank correlation coefficient for evaluating criterion-based validity between PCAM and INTERMED was 0.90. For reliability, Cronbach’s alpha was 0.85. According to negative binomial regression analyses, PCAM scores are a statistically significant predictor (p<0.001) of LOS after adjusting for age, gender, Mini Nutritional Assessment Short-Form, Charlson Comorbidity Index, serum sodium concentration, total number of medications and whether public assistance was required. In another model, each factor in PCAM was independently correlated with length of stay in hospital after adjustment (medicine-oriented complexity: p=0.001, patient-oriented complexity: p=0.014).ConclusionPCAM is a reliable and valid measurement of patient complexity and PCAM scores have a significant correlation with hospital length of stay.

Two Criteria for Good Measurements in Research: Validity and Reliability

“…Corey J. Hayes, Naleen Raj Bhandari, Niranjan Kathe, and Nalin Payakachat have analyzed reliability and validity of the Medical Outcomes Study Short Form-12, Version 2 in adults with non-cancer pain [Hayes et al, 2017]. Yoshida et al (2017) have analyzed the Patient Centred Assessment Method and have determined that is a valid and reliable scale for assessing patient complexity in the initial phase of admission to a secondary care hospital. Roberta Heale and Alison Twycross have briefly discussed the aspects of the validity and reliability in the quantitative research [Heale & Twycross, 2015].…”

Correlation of patient complexity with the burden for health-related professions, and differences in the burden between the professions at a Japanese regional hospital: a prospective cohort study

“…We performed this prospective cohort study along with a study investigating the validity and reliability of the PCAM 15. As is the case with the validation study, we adopted all inpatients admitted to the acute care unit of Ouji Coop Hospital between 1 July 2014 and 30 September 2014 as our participants.…”

“…Our hospital has no surgical facilities; patients needing surgical treatment are referred to other hospitals. During the study period, most inpatients were admitted to treat the following medical conditions: pneumonia, urinary tract infection, acute exacerbation of chronic illness (chronic obstructive pulmonary disease, diabetes), dermatological conditions such as decubitus ulcers and cellulitis, orthopaedic conditions such as lumbar compression and proximal femoral fractures that do not require surgery and cancer pain not being controlled in ambulatory or home medical care 15…”

“…The PCAM—an advanced version of the Minnesota Complexity Assessment Method developed in Scotland—is a practical tool for use in the primary care setting. We examined, in a Japanese secondary care setting, the validity and reliability of the PCAM and the relationship between PCAM and the length of hospital stay 15. We found that health problems needing concrete intervention were detectable using this method.…”

Reducing Emergency Room Visits and In‐Hospitalizations by Implementing Best Practice for Transitional Care Using Innovative Technology and Big Data

“…A second technological innovation was the development of an evidence‐based CDS tool to incorporate information about social and behavioral determinants of health into the EHR for exchange across healthcare settings. Researchers at the University of Minnesota Department of Family Medicine and Community Health developed the Patient Centered Assessment Method (PCAM; Maxwell, Hibberd, Pratt, Cameron, & Mercer, ; Pratt, Hibberd, Cameron, & Maxwell, ; Yoshida et al., ). The PCAM is a 12‐item screening tool with a four‐level rating scale of social and behavioral determinants of health.…”