Article Text
Abstract
Background A 2014 national audit used the English General Practice Patient Survey (GPPS) to compare service users’ experience of out-of-hours general practitioner (GP) services, yet there is no published evidence on the validity of these GPPS items.
Objectives Establish the construct and concurrent validity of GPPS items evaluating service users’ experience of GP out-of-hours care.
Methods Cross-sectional postal survey of service users (n=1396) of six English out-of-hours providers. Participants reported on four GPPS items evaluating out-of-hours care (three items modified following cognitive interviews with service users), and 14 evaluative items from the Out-of-hours Patient Questionnaire (OPQ). Construct validity was assessed through correlations between any reliable (Cochran's α>0.7) scales, as suggested by a principal component analysis of the modified GPPS items, with the ‘entry access’ (four items) and ‘consultation satisfaction’ (10 items) OPQ subscales. Concurrent validity was determined by investigating whether each modified GPPS item was associated with thematically related items from the OPQ using linear regressions.
Results The modified GPPS item-set formed a single scale (α=0.77), which summarised the two-component structure of the OPQ moderately well; explaining 39.7% of variation in the ‘entry access’ scores (r=0.63) and 44.0% of variation in the ‘consultation satisfaction’ scores (r=0.66), demonstrating acceptable construct validity. Concurrent validity was verified as each modified GPPS item was highly associated with a distinct set of related items from the OPQ.
Conclusions Minor modifications are required for the English GPPS items evaluating out-of-hours care to improve comprehension by service users. A modified question set was demonstrated to comprise a valid measure of service users’ overall satisfaction with out-of-hours care received. This demonstrates the potential for the use of as few as four items in benchmarking providers and assisting services in identifying, implementing and assessing quality improvement initiatives.
- Primary care
- Patient satisfaction
- Surveys
- Quality improvement
This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
Statistics from Altmetric.com
Supplementary materials
Supplementary Data
This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.
- Data supplement 1 - Online supplement
- Data supplement 2 - Online table 1
- Data supplement 3 - Online table 2
- Data supplement 4 - Online table 3
Footnotes
Contributors Each of the authors contributed to some (or all) of: the conception and design of the study, collection of data, analysis and interpretation of data. All authors were involved in drafting and/or critical revision of the manuscript and approved the final version.
Funding This study was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research (PGfAR) programme (RP-PG-0608-10050). We are grateful to NHS Cambridgeshire for their support funding LM.
Disclaimer The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research (NIHR) or the Department of Health.
Competing interests MR and JC act as academic advisors to Ipsos MORI for the GP Patient Survey. The other authors have no competing interests to declare.
Ethics approval The study was approved by the National Research Ethics Service Committee South Central—Berkshire B NHS Research Ethics Committee (12/SC/0454), and the appropriate research governance approvals were sought for each research site.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement A report of the preliminary cognitive interviewing undertaken in the pilot study is available to any interested parties. Please contact the corresponding author, SR.