Development and validation of the Patient Assessment of Chronic Illness Care (PACIC).
BACKGROUND
There is a need for a brief, validated patient self-report instrument to assess the extent to which patients with chronic illness receive care that aligns with the Chronic Care Model-measuring care that is patient-centered, proactive, planned and includes collaborative goal setting; problem-solving and follow-up support.


METHODS
A total of 283 adults reporting one or more chronic illness from a large integrated health care delivery system were studied.


METHODS
Participants completed the 20-item Patient Assessment of Chronic Illness Care (PACIC) as well as measures of demographic factors, a patient activation scale, and subscales from a primary care assessment instrument so that we could evaluate measurement performance, construct, and concurrent validity of the PACIC.


RESULTS
The PACIC consists of 5 scales and an overall summary score, each having good internal consistency for brief scales. As predicted, the PACIC was only slightly correlated with age and gender, and unrelated to education. Contrary to prediction, it was only slightly correlated (r = 0.13) with number of chronic conditions. The PACIC demonstrated moderate test-retest reliability (r = 0.58 during the course of 3 months) and was correlated moderately, as predicted (r = 0.32-0.60, median = 0.50, P < 0.001) to measures of primary care and patient activation.


CONCLUSIONS
The PACIC appears to be a practical instrument that is reliable and has face, construct, and concurrent validity. The resulting questionnaire is in the public domain, and recommendations for its use in research and quality improvement are outlined.
Glasgow
Russell E
RE
Kaiser Permanente Colorado, Denver, Colorado, USA. russg@ris.net
Wagner
Edward H
EH
Schaefer
Judith
J
Mahoney
Lisa D
LD
Reid
Robert J
RJ
Greene
Sarah M
SM
D000367:Age Factors; D002908:Chronic Disease / Q000628:therapy*; D019033:Delivery of Health Care, Integrated / Q000592:standards*; D019468:Disease Management; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007061:Idaho; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D018802:Patient-Centered Care / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration / Q000592:standards*; D011594:Psychometrics / Q000295:instrumentation*; D011787:Quality of Health Care; D015203:Reproducibility of Results; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014861:Washington