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Measuring patients' experiences and views of the emergency and urgent care system: psychometric testing of the urgent care system questionnaire
  1. Alicia O'Cathain,
  2. Emma Knowles,
  3. Jon Nicholl
  1. ScHARR, University of Sheffield, Sheffield, UK
  1. Correspondence to Dr Alicia O'Cathain, Medical Care Research Unit, ScHARR, University of Sheffield, Regent Street, Sheffield S1 4DA, UK; a.ocathain{at}


Background Patients seeking emergency and urgent care tend to experience a system, making choices about which service to use and making use of a number of services within a healthcare episode. The aim was to psychometrically test the Urgent Care System Questionnaire (UCSQ) for the routine measurement of the patient perspective of the emergency and urgent care system.

Methods The UCSQ was developed based on qualitative research with recent users of the system. It consisted of a screening question to identify recent users and questions on the patient experience of, and satisfaction with, their most recent event. The acceptability, validity and reliability of the UCSQ were tested in a postal survey of 900 members of the general population and a telephone survey of a quota sample of 1000 members of the general population.

Results The response rate to the postal survey was 51% (457/893). In the telephone survey, 11 604 calls were made to obtain a quota sample of 1014 people. These surveys identified 250 system users in the previous 3 months. A principal-components analysis identified three satisfaction components with good internal consistency (Cronbach alpha between 0.7 and 0.93): ‘progress through the system’ (10 items), ‘entry into the system’ (three items) and ‘patient convenience’ (five items). These components varied as expected by age and overall rating of the system.

Conclusion Preliminary testing suggests that the UCSQ has reasonable acceptability, validity and reliability. Further testing is required, particularly its responsiveness to changes in emergency and urgent care systems.

  • Patient satisfaction
  • healthcare quality
  • access and evaluation
  • emergencies

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  • Funding This work was undertaken by the Medical Care Research Unit, which is supported by the Department of Health. The views expressed here are those of the authors and not necessarily those of the Department.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the 07/Q2403/69 East Midlands Research Ethics Committee UK.

  • Provenance and peer review Not commissioned; externally peer reviewed.