title: Development and initial validation of a measure of coordination of health care.
abstract: OBJECTIVE
  To describe the development and initial validation of the self-administered Client Perceptions of Coordination Questionnaire.
  
  
  METHODS
  The instrument was developed between 1996 and 1997 through iterative item generation; within a framework of six domains of coordination, addressed across four sectors of health care provision.
  
  
  METHODS
  1193 individuals with complex and chronic health care needs as judged by their general practitioners (GPs), who were participants in a 2-year randomized controlled trial of a coordinated care intervention in Australia. Other samples were collected in one general practice (98) and from attendees of a chronic pain management course (29).
  
  
  METHODS
  Face and content validity, completion rates, transferability, internal consistency, and construct validity of the 32-item instrument.
  
  
  RESULTS
  Most items achieved excellent completion and comprehension rates. The instrument was transferable to another chronically unwell population. Cronbach's alpha of the entire instrument was 0.92, and for six individual scales scores ranged from 0.31 to 0.86. The six scales based on principal components analysis were acceptability, received care, GP, nominated provider, client comprehension, and client capacity. The first four scales were satisfactory, but the client scales were inadequate with poor internal consistency, and convergent and discriminant validity. People with chronic pain syndromes had significantly worse experiences for almost all items, supporting construct validity.
  
  
  CONCLUSIONS
  This instrument is one of the first to attempt to measure coordination of health care. Its strengths include ease of completion, transferability, and promising psychometric properties and construct validity. Problems capturing data about the patient's contribution to coordination highlight a lack of theoretical development in this area. A valid measure of coordination should be useful in needs assessment, program evaluation, and individual provider/practice audit, and would contribute to research into the experience and measurement of patient-focused care.
authors.affiliation: National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory 0200, Australia. clare.mcguiness@calvary-act.com.au
authors.forename: Clare
authors.initials: C
authors.lastname: McGuiness
authors.forename: Beverly
authors.initials: B
authors.lastname: Sibthorpe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D032882:Comprehension; D003266:Continuity of Patient Care; D016002:Discriminant Analysis; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D011594:Psychometrics; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires