Reliability and validity of a new measure of patient satisfaction with out of hours primary medical care in the united kingdom: development of a patient questionnaire

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Abstract
Objective: To develop a reliable, valid measure of patient satisfaction with out of hours care suitable for large scale service evaluation. Design: Focus group meetings and semistructured interviews with patients to identify issues of importance to patients and possible questionnaire items; interviews and two pilot studies to test and identify new questionnaire items; modification or removal of items to eliminate ambiguity and reduce non-response and skewed responses; questionnaire survey of out of hours care. Setting: Greater Manchester and Leicester. Subjects: 11 general practice patients participated in the focus groups and 28 in the semistructured interviews; 41 in the preliminary interviews; 41 and 378 in the postal pilots; and 1466 in the survey of out of hours care. Results: A 32 item questionnaire was developed. Component analysis indicated seven scales (satisfaction with communication and management, doctor's attitude, continuity of care, delay until visit, access to out of hours care, initial contact person, telephone advice) related to overall satisfaction and containing issues identified as important to patients. Levels of reliability were satisfactory, Cronbach's α correlation coefficient exceeding 0.60 for all scales. Conclusion: A reliable, valid measure of patient satisfaction has been developed, suitable for large scale evaluation of out of hours care. The provision of out of hours primary medical care is changing, and these changes need to be evaluated and monitored Patient satisfaction is an important measure of the outcome of health care A reliable and valid measure of patient satisfaction with out of hours primary medical care has been developed Development of such scales is demanding on time and experience but is feasible Ad hoc measures of satisfaction should be avoided and when possible reliable, valid scales used