MOSAIC – a Rasch analysed item bank to measure person-centred care

About the project

The delivery of person centred care (PCC) is now a priority for modern healthcare systems across Europe. PCC strives to support the attainment of a person’s own realistic health and life goals by eliciting individuals’ values and preferences to guide all aspects of their health care. PCC has been shown to be effective at improving health outcomes, and reducing service cost in patients with long-term conditions. However, it the UK and many other settings, person centred care also requires effective care coordination, particularly for people with long-term conditions. Measuring person centred (PCC) and coordinated care (P3C) and feeding information back to improve care has been limited and still faces a number of challenges.

Current approaches to the measurement of patient experiences of care use questionnaires. Questionnaires typically focus on either healthcare outcomes, healthcare experiences, or a mix of the two. Common criticisms of questionnaires are that they are either too generic (contain generalist questions that do not capture the essence of person centred care) or are too specific (i.e. focusing on one area of person centred care such as communication). Questionnaires are often not focused on those who could most benefit from improvements in care, and are infrequently used. More often than not the results of questionnaires are not used as feedback to services to improve the delivery of care or to patients to improve their participation in care. In addition, the maths used to assess the questionnaire response has been criticised as being inappropriate, leading some health researchers and doctors to question the use of questionnaires at all. The complex way of collecting questionnaires and analysing the responses often means a researcher is needed to collect the data and give feedback to healthcare staff and patients. This drives up costs and often limits the benefits to the length of the study period.

Although there are problems with using questionnaires, they are a good way of measuring PCC and care coordination in health services as they give patients the chance to speak about their care and inform the services about their experiences of the healthcare they receive. Improvements are needed to ensure PCC or P3C is measured well, and that the data is used to improve health services. Until PCC and care coordination can be measured accurately, we are unable to determine if we are improving person centeredness and coordination within care settings.

Aim of the project

Our project will develop, culturally adapt, Rasch analyse and test an item bank and a new adaptive questionnaire that addresses the concerns about the current questionnaires being used. The questionnaire will use what is known as a computer adaptive test (CAT), capable of adapting questions to the person answering. This will reduce the need to ask unnecessary questions and improve the accuracy of the questionnaire.