title: Developing IntegRATE: a fast and frugal patient-reported measure of integration in health care delivery.
abstract: BACKGROUND
  Efforts have been made to measure integration in health care delivery, but few existing instruments have adopted a patient perspective, and none is sufficiently generic and brief for administration at scale. We sought to develop a brief and generic patient-reported measure of integration in health care delivery.
  
  
  METHODS
  Drawing on both existing conceptualisations of integrated care and research on patients' perspectives, we chose to focus on four distinct domains of integration: information sharing, consistent advice, mutual respect and role clarity. We formulated candidate items and conducted cognitive interviews with end users to further develop and refine the items. We then pilot-tested the measure.
  
  
  RESULTS
  Four rounds of cognitive interviews were conducted (n = 14) and resulted in a four-item measure that was both relevant and understandable to end users. The pilot administration of the measure (n = 15) further confirmed the relevance and interpretability of items and demonstrated that the measure could be completed in less than one minute.
  
  
  CONCLUSIONS
  This new measure, IntegRATE, represents a patient-reported measure of integration in health care delivery that is conducive to use in both routine performance monitoring and research. The psychometric properties of the measure will be assessed in the next stage of development.
authors.affiliation: The Dartmouth Center for Health Care Delivery Science, The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, NH, USA.
authors.forename: Glyn
authors.initials: G
authors.lastname: Elwyn
authors.affiliation: The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, NH, USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Thompson
authors.affiliation: The Dartmouth Center for Health Care Delivery Science, Dartmouth College, Hanover, NH, USA.
authors.forename: Roshen
authors.initials: R
authors.lastname: John
authors.affiliation: The Dartmouth Center for Health Care Delivery Science, Dartmouth College, Hanover, NH, USA.
authors.forename: Stuart W
authors.initials: SW
authors.lastname: Grande
keywords: care coordination; cognitive interviews; continuity of care; integration of care; measurement; patient-reported measures