In an effort to evaluate primary care systems internationally, the Organisation for Economic Co-operation and Development (OECD) has introduced the PaRIS survey. This initiative aims to gather insights into health systems’ performance by examining the care experiences and outcomes of individuals over 45 who have utilized primary care services in the last six months. The survey also includes data from primary care practices to understand how their organization and processes affect patient care. The focus of this article is on the development and validation of the primary care practice questionnaire, known as the PaRIS-PCPQ.
Development Process
The PaRIS-PCPQ was formulated based on domains of primary care practice and professional characteristics outlined in the PaRIS conceptual framework. Its development occurred over four phases. Initially, a source questionnaire was created through a multi-step consensus-based approach. This was followed by translating the English questionnaire into 17 different languages. Next, cross-national cognitive testing was performed with primary care professionals from participating countries. Finally, the questionnaire underwent cross-national field-testing to ensure its reliability and validity.
Results of Testing
From the initial 70 items drawn from seven existing questionnaires, 49 were selected for the first draft. Stakeholder feedback refined this to a 34-item version, which encompasses practice profile, care coordination, chronic care management, patient follow-up, and respondent characteristics. This version was designed to be completed by medical or non-medical staff working in primary care practices. Cognitive testing led to further revisions and country-specific adaptations, resulting in a 32-item questionnaire that was piloted in an online survey and field test. Data from 540 primary care practices across 17 countries were collected and analyzed, leading to a final 34-item version.
User-Usable Inferences
Key takeaways from the survey development process include:
- Effective cross-national survey development requires rigorous translation and cognitive testing to accommodate diverse healthcare systems.
- Stakeholder engagement is critical to refining and validating survey items.
- Online survey platforms can facilitate the collection of comprehensive data from a wide range of primary care practices.
- Insights from such surveys can inform policymakers and providers about the performance of primary care from a patient’s perspective, especially for those with chronic conditions.
The PaRIS-PCPQ’s cross-national development highlighted the complexities of creating a uniform questionnaire suitable for diverse healthcare settings. However, through meticulous translation, cognitive testing, and stakeholder collaboration, most challenges were addressed effectively. The finalized PaRIS-PCPQ will serve as a valuable tool for assessing the relationship between primary care practice characteristics and the care experiences and outcomes of patients with chronic conditions.
Original Article: BMC Prim Care. 2024 May 17;25(1):168. doi: 10.1186/s12875-024-02375-8. PMID: 38760733 | DOI: 10.1186/s12875-024-02375-8
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