[Patient surveys as an element of quality management in outpatient care: development and assessment of a questionnaire].
OBJECTIVE
The present study was designed to develop and assess a questionnaire measuring all relevant quality dimensions of general practice care from the patients' perspective. Furthermore, the study aimed to evaluate the implementation of a patient survey in outpatient care.


METHODS
Based on the Kölner Patientenfragebogen (KPF) and by developing some additional new items, we created the new questionnaire KPF-A (Kölner Patientenfragebogen-ambulant) which covers all relevant aspects of outpatient care. The questionnaire was distributed to the patients of 41 GP's and specialists in ambulatory care from different regions of Germany. N=3188 patients were included in the sample. We used these data to assess some selected psychometric characteristics of the KPF-A. Factor analysis was used to examine the underlying factor structure. A qualitative study was conducted to evaluate the implementation of the patient survey. Therefore, all N=41 doctors involved were asked to complete five open questions concerning their experience.


RESULTS
Most scales of the KPF-A showed good psychometric characteristics in the present study. Factor analysis revealed a two-factors solution for the new items representing the dimensions "professional competence" and "medical equipment". We have not yet been able to find a sound factor solution for those items representing the dimension "Staff and Organisation". The results of the qualitative study revealed a satisfying implementation of the patient survey in daily routine from the doctors' perspective. The length of the questionnaire was criticised by some participants. In the design of the study patients were supposed to fill in the questionnaires after consultation. This turned out to be difficult. We therefore modified the KPF-A so that patients can fill it in either before or after consultation.
Brinkmann
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Abteilung Medizinische Soziologie des Instituts und der Poliklinik für Arbeits- und Sozialmedizin, Medizinische Fakultät der Universität zu Köln, Köln. anne.brinkmann@uk-koeln.de
Steffen
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Pfaff
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D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000592:standards*; D002983:Clinical Competence / Q000592:standards; D005194:Family Practice / Q000592:standards; D005260:Female; D005858:Germany; D006306:Health Surveys; D006801:Humans; D008297:Male; D008511:Medicine / Q000592:standards; D008875:Middle Aged; D010865:Pilot Projects; D015397:Program Evaluation; D011594:Psychometrics / Q000706:statistics & numerical data; D012680:Sensitivity and Specificity; D013038:Specialization; D011795:Surveys and Questionnaires; D017749:Total Quality Management / Q000458:organization & administration*