ABSTRACT
The integration of care between primary, secondary, tertiary health care and social care needs to be interprofessional and patient-centered. The aim of this study was to develop and validate a questionnaire for measuring patients’ perception of integration across health care teams and social services. Data for psychometric assessment of our questionnaire were collected from patients who attended at eleven Primary Care Centers and one tertiary referral Hospital in Spain from March to October 2018. The questionnaire was tested in a pilot study with 40 patients before being administered in a sample of 279 patients. The questionnaires were distributed in urban Health Centers, peri-urban or rural Health Centers (67%) and a tertiary referral hospital (33%). The questionnaire included 9 items that measured patient perceived experiences about care coordination, data accessibility and delivery of clinical information. The model explained 51% of the variation in the data and Cronbach’s alpha was 0.8. Two factors comprising perception of coordination and assessment of patient-centered care were identified. The overall perception for integration was low. The reliability and validation of our questionnaire showed its potential as a valuable instrument for assessing patients’ perception of the integration of care and can be used within the quality metrics to assess the success of integrated health care management programs.
Disclosure statement
The authors declare that there is no conflict of interest.
Data availability statement
Raw data were generated at GASBI (Gerencia de Atención Sanitaria del Bierzo). Derived data supporting the findings of this study are available from the corresponding author LC-G upon reasonable request.
Ethics
The study was evaluated and approved by the Clinical Research Ethics Committee of León and El Bierzo Health Areas.
Supplementary material
Supplemental data for this article can be accessed on the publisher’s website.
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Notes on contributors
Iris Parra-Vega
Iris Parra-Vega, NP, is a nurse in the Internal Medicine Ward at the Hospital El Bierzo, Ponferrada, Leon, Spain. She earned a master’s degree in research in Social and Health Sciences at the University of Leon, Spain. The present work is part of her master’s dissertation focused on the integration of the patients’ point of view in projects to improve coordination between Health Care levels.
Pilar Marqués-Sánchez
Pilar Marqués-Sánchez, Professor in Health Science, Head of SALBIS Research Group, Head Management of Campus de Ponferrada at the University of Leon. Her topics are focused on Health Management and Public Health. She has coordinated a core of projects related to healthy environment and management and she has been a host professor in several universities in EE.UU and U.K.
José M. Pelayo-Terán
José M. Pelayo-Terán, MD, PhD is Psychiatrist and the current Head of the Unidad de Calidad y Seguridad del Paciente (Patients’ Quality and Security Unit) in the “Gerencia de Asistencia Sanitaria El Bierzo” (GASBI) Leon. He is also the Head of postgraduate training at El Bierzo Hospital and the coordinator of the support research team. From 2016 to 2018 he was part of the working group that participated in the Integration Plan of the GASBI. In 2019 he leads the promotion of the integrated area into the 400 + EFQM model. Associate professor for the Preventive Medicine and Public Health area at the University of Leon and collaborative member of the 394 research group GIIGAS (the group of research interaction gene-environment health). Accredited research member in the CB07/09/2001 group of the national research networking CIBERSAM (CIBER Mental Health: Mental Health Networking Biomedical Research Centre).
Luis Corral Gudino
Luis Corral Gudino, MD, Ph.D. is an Adjunct Professor in the Institute of Medicine, Dermatology, and Toxicology at the University of Valladolid and a Consultant in Internal Medicine at the Hospital Universitario Río Hortega, Valladolid. The former head of the Patients’ Quality and Security Unit in the “Gerencia de Asistencia Sanitaria El Bierzo” (GASBI) Leon, Spain. He coordinated a project to improve collaboration and information sharing between primary, secondary, tertiary, and community care in El Bierzo Health Care Area during the 2016-2018 period.