Despite the many interventions and trials aimed at improving coordination of health care, there is currently no accepted measurement of coordination. My professional interests and an opportunity provided by the Care Plus (Coordinated Care) Trial in the ACT led me to consider client perceptions as a potentially appropriate measure. My research question is can coordination of health care be usefully measured through client perceptions?
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I addressed this question by developing and testing an instrument to measure perceptions of coordination called the Client Perceptions of Coordination Questionnaire (CPCQ). In the thesis I describe the processes of developing the instrument, testing it through use in several studies and considering how useful such an instrument may be for health services research. In addition to the Coordinated Care Trial, I conducted two validation studies - in a chronic pain population and a general practice sample.
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In Part 1 of the results I demonstrate good face, content and discriminant validity, and reliability of the instrument. Psychometric analysis of the CPCQ did not support scaling, and identified areas were the instrument could be improved. Nevertheless the underlying construct of client perception of coordination as a measure is entirely new, and it is therefore worthwhile to explore its associations with other health outcome data. In Part 2 I use a single item from the CPCQ, how often did you feel the care you received was well-coordinated? to explore this construct. I explore the influences upon on client perceptions of coordination, and examine its associations with service utilisation and health outcome data.
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The construct of perceived coordination, and the capacity of the CPCQ to measure it accurately show considerable promise as measures of health care. Consistent trends were found that suggested coordination was a complex construct, and that a stronger theoretical base was needed to interpret this complexity. Theory is the first of the phases of instrument development, and so I revisit these in order to summarise the strengths and weaknesses of the current CPCQ. Overall, the perceptions of coordination have surprisingly plausible associations with other health data, the effort to improve the instrument should be worthwhile for a wide range of health service evaluation and research.
| Identifer | oai:union.ndltd.org:ADTP/216713 |
| Date | January 2001 |
| Creators | McGuiness, Clare Frances, clare.mcguiness@calvary-act.com.au |
| Publisher | The Australian National University. National Centre for Epidemiology and Population Health |
| Source Sets | Australiasian Digital Theses Program |
| Language | English |
| Detected Language | English |
| Rights | http://www.anu.edu.au/legal/copyright/copyrit.html), Copyright Clare Frances McGuiness |
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