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Patient Experience in an Era of Primary Care Transformation: Revisiting the PACIC
Abstract
Rationale, Aims and Objective: The validation study of thePatient Assessment of Chronic Illness Care (PACIC) questionnaire suggested a 5-factor structure determined a priori, but subsequent analyses have questioned the validity of the original factor structure. This study analyzed the factor structure of the PACIC using a large and diverse patient sample and evaluated the identified factors through the lens of recent transformational initiatives in primary care.
Methods: Exploratory and confirmatory factor analyses were conducted on baseline and follow-up patient questionnaire data from a cluster randomized controlled trial. Convenience samples of adults completed surveys in waiting rooms during clinic visits. Primary care patients with 1 or more chronic illnesses with complete PACIC responses at baseline from 39 clinics (n=1,567) and at follow-up from 36 clinics (n=1,536) participated. Identified factors were evaluated in terms of item loadings, content, reliability and the extent to which items reflected advances in the delivery of chronic illness care.
Results: Analyses supported the use of the PACIC summary score. Although a 5-factor model was retained, factor loadings were different from the original PACIC validation study. All factors had sufficient reliability, but findings suggested potential revisions to enhance the factor structure.
Conclusions: It may be time to revise the PACIC to enhance the stability of the subscales (factors) and better reflect recent transformations in the delivery of chronic illness care.
Keywords
References
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DOI: http://dx.doi.org/10.5750/ejpch.v4i3.1160
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