Readiness to tackle chronicity in Spanish health care organisations: a two-year experience with the Instrumento de Evaluación de Modelos de Atención ante la Cronicidad/Assessment of Readiness for Chronicity in Health Care Organisations instrument.
BACKGROUND
The Instrumento de Evaluación de Modelos de Atención ante la Cronicidad/Assessment of Readiness for Chronicity in Health Care Organisations instrument was developed to implement the conceptual framework of the Chronic Care Model in the Spanish national health system. It has been used to assess readiness to tackle chronicity in health care organisations. In this study, we use self-assessments at macro-, meso- and micro-management levels to (a) describe the two-year experience with the Instrumento de Evaluación de Modelos de Atención ante la Cronicidad/Assessment of Readiness for Chronicity in Health Care Organisations tool in Spain and (b) assess the validity and reliability of this instrument.


METHODS
The results from 55 organisational self-assessments were included and described. In addition to that, the internal consistency, reliability and construct validity of Instrumento de Evaluación de Modelos de Atención ante la Cronicidad/Assessment of Readiness for Chronicity in Health Care Organisations were examined using Cronbach's alpha, the Spearman-Brown coefficient and factorial analysis.


RESULTS
The obtained scores reflect opportunities for improvement in all dimensions of the instrument. Cronbach's alpha ranged between 0.90 and 0.95 and the Spearman-Brown coefficient ranged between 0.77 and 0.94. All 27 components converged in a second-order factorial solution that explained 53.8% of the total variance, with factorial saturations for the components of between 0.57 and 0.94.


CONCLUSIONS
Instrumento de Evaluación de Modelos de Atención ante la Cronicidad/Assessment of Readiness for Chronicity in Health Care Organisations is an instrument that allows health care organisations to perform self-assessments regarding their readiness to tackle chronicity and to identify areas for improvement in chronic care.
Alicante-Sant Joan d'Alacant Health District, Consellería de Sanidad, Alicante and Professor, Miguel Hernández University, Elche, Alicante, Spain.
José Joaquín
JJ
Mira
Deusto Business School Health, University of Deusto, Bilbao, Spain.
Roberto
R
Nuño-Solinís
Merck Sharp & Dohme España (MSD), Madrid, Spain.
Paloma
P
Fernández-Cano
Chronic Prevention and Care Programme, Department of Health, Servicio Catalán de la Salud (CatSalut), Barcelona, Spain.
Joan Carlos
JC
Contel
Department of Health Psychology, Miguel Hernández University, Elche, Alicante, Spain.
Mercedes
M
Guilabert-Mora
International Consultant on Health Policies and Management Organizations and Associated Researcher in New Health Foundation, Spain.
Olga
O
Solas-Gaspar
chronic illness; measurement; quality improvement; self-assessment