Quality of chronic disease care in general practice: the development and validation of a provider interview tool.
BACKGROUND
This article describes the development and psychometric evaluation of an interview instrument to assess provider-reported quality of general practice care for patients with diabetes, cardiovascular disease and asthma--the Australian General Practice Clinical Care Interview (GPCCI).


METHODS
We administered the GPCCI to 28 general practitioners (family physicians) in 10 general practices. We conducted an item analysis and assessed the internal consistency of the instrument. We next assessed the quality of care recorded in the medical records of 462 of the general practitioners' patients with Type 2 diabetes, ischaemic heart disease/hypertension and/or moderate to severe asthma. This was then compared with results of the GPCCI for each general practice.


RESULTS
Good internal consistency was found for the overall GPCCI (Cronbach's alpha = 0.75). As far as the separate sub-scales were concerned, diabetes had good internal consistency (0.76) but the internal consistency of the heart disease and asthma subscales was not strong (0.49 and 0.16 respectively). There was high inter-rater reliability of the adjusted scores of data extracted from patients' medical notes for each of the three conditions. Correlations of the overall GPCCI and patients' medical notes audit, combined across the three conditions and aggregated to practice level, showed that a strong relationship (r = 0.84, p = 0.003) existed between the two indices of clinical care.


CONCLUSIONS
This study suggests that the GPCCI has good internal consistency and concurrent validity with patients' medical records in Australian general practice and warrants further evaluation of its properties, validity and utility.
Proudfoot
Judith
J
Centre for Primary Health Care and Equity, School of Public Health & Community Medicine, University of New South Wales, Sydney, NSW, Australia. j.proudfoot@unsw.edu.au
Jayasinghe
Upali W
UW
Infante
Fernando
F
Beilby
Justin
J
Amoroso
Cheryl
C
Davies
Gawaine Powell
GP
Grimm
Jane
J
Holton
Christine
C
Bubner
Tanya
T
Harris
Mark
M
D001249:Asthma / Q000628:therapy; D001315:Australia; D002318:Cardiovascular Diseases / Q000628:therapy; D003920:Diabetes Mellitus / Q000628:therapy; D019468:Disease Management; D005194:Family Practice / Q000379:methods*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D011785:Quality Assurance, Health Care / Q000379:methods*; D015203:Reproducibility of Results