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Quality of Life Research

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01.09.2007 | Original Paper

Measuring quality of health care from the user’s perspective in 41 countries: psychometric properties of WHO’s questions on health systems responsiveness

verfasst von: N. B. Valentine, G. J. Bonsel, C. J. L. Murray

Erschienen in: Quality of Life Research | Ausgabe 7/2007

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Abstract

Objective

To evaluate, for different populations, psychometric properties of questions on “health systems responsiveness”, a concept developed by World Health Organization (WHO) to describe non-clinical and non-financial aspects of quality of health care.

Data sources/study setting/data collection

The 2000–2002 WHO Multi-Country Study comprised 70 general population surveys. Forty-one surveys were interviewer-administered, from which we extracted respondent records indicating ambulatory and inpatient health services use (excluding long-term institutions) in the previous 12 months (50,876 ambulatory and 7,964 hospital interviews).

Study design

We evaluated feasibility, reliability, and construct validity using 33 items with polytomous response options, comparing responses from populations identified by countries, sex, age, education, health and income.

Principal findings

Average item missing rates ranged from 0 to 16%. Domain-specific alpha coefficients exceeded 0.7 in 7 (of 9) cases. Average intertemporal reliability was acceptable in 6 (of 10) sites, where Kappas ranged from 0.54 to 0.79, but low in 4 sites (K < 0.5). Kappa statistics were higher for male, educated and healthier populations than for female, less educated and less healthy populations. Factor solutions confirmed the domain structure of 7 domains (only 7 were operationalized for ambulatory settings). As in other studies, higher incomes and age was associated with more positive responsiveness reports and ratings.

Conclusions

Quality issues addressed by WHO’s questions are understood and reported adequately across diverse populations. More research is needed to interpret user-assessed quality of care comparisons across population groups within and between countries.

Nur mit Berechtigung zugänglich

High human development - Argentina, Bahrain, Belgium, Canada (telephone), Costa Rica, Croatia, Czech Republic, Estonia, Finland, France, Germany, Iceland, Ireland, Italy, Latvia, Luxembourg, Malta, Mexico (long survey - 9 modules), Portugal, Slovakia (long), Spain, Sweden, The Netherlands, United Arab Emirates. Low human development—Bulgaria, China (long), Colombia (long), Egypt (long), Georgia (long), India (long), Indonesia (long), Iran (long), Jordan, Morocco, Nigeria (long), Oman, Romania, Russian Federation, Syria (long), Turkey (long), Venezuela.

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Titel: Measuring quality of health care from the user’s perspective in 41 countries: psychometric properties of WHO’s questions on health systems responsiveness
verfasst von: N. B. Valentine
G. J. Bonsel
C. J. L. Murray
Publikationsdatum: 01.09.2007
Verlag: Springer Netherlands
Erschienen in: Quality of Life Research / Ausgabe 7/2007
Print ISSN: 0962-9343
Elektronische ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-007-9189-1

Springer Medizin

Abstract

Objective

Data sources/study setting/data collection

Study design

Principal findings

Conclusions

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