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Development and Validation of the Older Patient Assessment of Chronic Illness Care (O-PACIC) Scale After Hospitalization
Authors:Jane M Cramm  Anna P Nieboer
Institution:1. Institute of Health Policy and Management (iBMG), Erasmus University, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, The Netherlands
Abstract:Objectives of this study were to develop and validate an instrument to assess older patients’ experiences with integrated care delivery after hospitalization. Our study was conducted among older individuals (≥65) who had recently been discharged from a hospital. At T1, 3 months after hospital admission, 296/457 patients (65 % response) were interviewed in their homes. At T2 12 months after hospital admission, 242/436 patients (56 % response) were interviewed. Point of departure for the development of the scale was the 20-item Patient Assessment of Chronic Illness Care (PACIC), which is proven to be a valid measure to assess chronically-ill patients’ assessment of integrated primary care delivery. We tested both the PACIC and new instrument by means of structural equation modeling, and examined its validity and reliability. After eliminating 10 items of the PACIC, the confirmatory factor analyses revealed good indices of fit with the 10-item Older Patient Assessment of Chronic Illness Care (O-PACIC) Scale. To estimate construct validity of the instrument, we looked at correlations between PACIC and O-PACIC scores and the satisfaction with stroke care home subscale (SASC-Home) questionnaire. Both the PACIC and O-PACIC significantly correlated with SASC-Home subscale (at p ≤ 0.001), which indicated validity. This study demonstrated that O-PACIC is a feasible, reliable and valid tool, with strong psychometric properties. We conclude that the O-PACIC is a promising instrument to evaluate integrated care delivery after hospitalization among older patients.
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