3024.0: Monday, November 13, 2000 - Board 3

Abstract #5868

Measuring primary health care quality dimensions: How response scales influence optimum outcomes and predictors of quality

Miguel A. Zuniga, MD, DrPH and Peter J. Fos, DDS,, PhD. Health Systems Management SL29, Tulane University, 1430 Tulane Avenue, New Orleans, LA 70112, 504.588.5428, mzuniga@mailhost.tcs.tulane.edu

These research findings are from administering quality of care assessment instruments to primary care users in Tegucigalpa, Honduras. Two response scales were evaluated to determine impact on item-specific response and predictive utility of assessed quality dimensions. Objective: To assess the influence of response scales on rate of responses and predictors of quality. Design: A 15-item questionnaire was designed to assess access, acceptability, personal competence and outcomes. Five-point ordinal response scales varying from EXCELLENT to POOR (E-P) and VERY GOOD to VERY POOR (VG-VP) were used. Gender, year of birth, type of visit, provider gender and first/subsequent visit control variables were collected. Subjects: The study population from an ambulatory facility was randomly divided into Group One (n=127) responding to E-P scale, and Group Two (n=115) responding to VG-VP scale. Statistical Analysis: Descriptive statistics and OLS regression determined change in R2 of variables entering the model. Control variables were constant. To minimize the family-wise error rate, independent variables entered only if the F-statistic was significant at p <.05. Results and Conclusion: Group One had a higher percentage of optimum (E vs. VG) responses in 12/15 assessed dimensions and important predictors were the 'opportunity to ask questions during visit' and 'convenience of clinic location.' Group Two important predictors were 'advised received during visit' and 'courtesy/respect shown by provider.' Different measurement techniques lead to different results, caution should be contemplated when adapting or developing surveys for perception measurement. The results are encouraging because aspects of care can be improved by influencing provider behavior and management style.

Learning Objectives: List four dimensions of quality of primary care; Evaluate differing outcomes from different inputs; Describe the predictive value of quality assessment

Keywords: Quality of Care, Survey

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA