title: [Design and validation of a questionnaire to measure continuity between care levels from the user's perspective].
abstract: OBJECTIVE
  To design and validate an instrument that measures continuity between levels of care from the user's perspective to be applied in any healthcare system providing a continuum of care.
  
  
  METHODS
  1) A questionnaire for the measurement of continuity of care was designed, based on a literature review, and 2) the questionnaire was validated using an expert group, two pretests and a pilot test to a sample of 200 healthcare users. We assessed the questionnaire's comprehensibility, content validity and interviewer burden, as well as the reliability and construct validity of the scale.
  
  
  RESULTS
  The instrument encompasses three types of continuity (management, information and relational) and is divided in two complementary parts. The first part addresses the patients' care pathways and the continuity of care for a particular episode that occurred in the last 3 months. The second part measures patients' perception of the continuity between levels of care. The experts agreed that all dimensions of continuity were represented and the interviewees found the questionnaire easy to understand. The mean time required to apply the instrument was 33.9 min. Cronbach's alpha was acceptable (>0.7) in all subscales except one, which was then removed. The multiple correspondence analyses showed associations among theoretically related items.
  
  
  CONCLUSIONS
  The questionnaire (CCAENA) seems to be an useful, valid and reliable instrument to assess comprehensively continuity between levels of care from the user's perspective. Further information about the questionnaire's psychometric properties will be obtained by applying it to a larger population.
authors.affiliation: Grup de Recerca en Polítiques de Salut i Serveis Sanitaris, Servei d'Estudis i Prospectives en Polítiques de Salut, Consorci de Salut i Social de Catalunya, Barcelona, España.
authors.forename: María José
authors.initials: MJ
authors.lastname: Letelier
authors.forename: Marta Beatriz
authors.initials: MB
authors.lastname: Aller
authors.forename: Diana
authors.initials: D
authors.lastname: Henao
authors.forename: Inma
authors.initials: I
authors.lastname: Sánchez-Pérez
authors.forename: Ingrid
authors.initials: I
authors.lastname: Vargas Lorenzo
authors.forename: Jordi
authors.initials: J
authors.lastname: Coderch de Lassaletta
authors.forename: Josep
authors.initials: J
authors.lastname: Ramon Llopart
authors.forename: Manel
authors.initials: M
authors.lastname: Ferran
authors.forename: Lluís
authors.initials: L
authors.lastname: Colomés
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Vázquez Navarrete
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003266:Continuity of Patient Care / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011795:Surveys and Questionnaires; D055815:Young Adult