title: Measuring chronic care management experience of patients with diabetes: PACIC and PACIC+ validation.
abstract: BACKGROUND
  The patient assessment of chronic illness care (PACIC) is a promising instrument to evaluate the chronic care experiences of patients, yet additional validation is needed to improve its usefulness.
  
  
  METHODS
  A total of 1941 patients with diabetes completed the questionnaire. Reliability coefficients and factor analyses were used to psychometrically test the PACIC and PACIC+ (i.e. PACIC extended with six additional multidisciplinary team functioning items to improve content validity). Intra-class correlations were computed to identify the extent to which variation in scores can be attributed to GP practices.
  
  
  RESULTS
  The PACIC and PACIC+ showed a good psychometric quality (Cronbach's alpha's >0.9). Explorative factor analyses showed inconclusive results. Confirmative factor analysis showed that none of the factor structures had an acceptable fit (RMSEA>0.10). In addition, 5.1 to 5.4% of the total variation was identified at the GP practice level.
  
  
  CONCLUSIONS
  The PACIC and PACIC+ are reliable instruments to measure the chronic care management experiences of patients. The PACIC+ is preferred because it also includes multidisciplinary coordination and cooperation-one of the central pillars of chronic care management-with good psychometric quality. Previously identified subscales should be used with caution. Both PACIC instruments are useful in identifying GP practice variation.
authors.affiliation: Scientific Centre for Care and Welfare (Tranzo), Tilburg University, The Netherlands; and National Institute for Public Health and the Environment, Centre for Prevention and Health Services Research, Bilthoven, The Netherlands.
authors.forename: Hanneke W
authors.initials: HW
authors.lastname: Drewes
authors.forename: Janneke T
authors.initials: JT
authors.lastname: de Jong-van Til
authors.forename: Jeroen N
authors.initials: JN
authors.lastname: Struijs
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Baan
authors.forename: Fetene B
authors.initials: FB
authors.lastname: Tekle
authors.forename: Bert R
authors.initials: BR
authors.lastname: Meijboom
authors.forename: G P
authors.initials: GP
authors.lastname: Westert
keywords: PACIC; chronic care management; chronic care model; diabetes; integrated care; patient experience