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Measuring Older Peoples’ Experiences of Person-Centred Coordinated Care:Experience and Methodological Reflections from Applying a Patient Reported Experience Measure in SUSTAIN

Reynolds, Jillian, Gadsby, E.W., Rijken, Mieke, Stoop, Annerieke, ESPALLARGUES, Mireia, Lloyd, Helen M, Close, James, De Bruin, Simone (2021) Measuring Older Peoples’ Experiences of Person-Centred Coordinated Care:Experience and Methodological Reflections from Applying a Patient Reported Experience Measure in SUSTAIN. International Journal of Integrated Care, . Article Number ijic.5504. ISSN 1568-4156. (doi:10.5334/ijic.5504) (KAR id:89329)

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Abstract

Introduction: While several evaluation studies on (cost-)effectiveness of integrated care have been conducted in recent years, more insight is deemed necessary into integrated care from the perspective of service users. In the context of a European project on integrated care for older people living at home (SUSTAIN), this paper shares the experience and methodological reflections from applying a Patient Reported Experience Measure (PREM) on person-centred coordinated care -the P3CEQ- among this population. Methods: A combination of quantitative and qualitative data and analysis methods was used to assess the usability and the quality of applying a PREM among older people presenting complex care needs, using the P3CEQ delivery in SUSTAIN as a case study. 228 service users completed the P3CEQ and nine SUSTAIN researchers participated in a consultation about their experience administering the questionnaire. P3CEQ scores were analysed quantitatively using principal component analysis and multilevel linear regression. P3CEQ open responses and researcher notes collected when administering the questionnaire were thematically analysed. Results: Service user inclusion was high and most P3CEQ items had low non-response rates. Quantitative analysis and researcher experience indicate the relevance of face-to-face administration for obtaining such an amount of data in this population group. The presence of a carer increased inclusion of more vulnerable respondents, such as the cognitively impaired, but posed a challenge in data interpretation. Although several P3CEQ items were generally understood as intended by questionnaire developers, the analysis of open responses highlights how questions can lead to diverging and sometimes narrow interpretations by respondents. Cognitive impairment and a higher educational attainment were associated with lower levels of perceived person-centredness of care. Conclusion: This study shows essential preconditions to meaningfully collect and analyse PREM data on older peoples’ experiences with integrated care: face-to-face administration away from care providers, collection of reasons for non-response and open comments providing nuances to answers, and multilevel modelling taking into account diversity in the target population. Several areas of improvement for future PREM use in this population have been identified: use of administration and coding guides, inclusion of clear and easy to understand definitions and examples illustrating what questions do and do not mean, measures of the expectations of person-centred coordinated care, and procedures ensuring sound ethical research. These methodological learnings can enhance future evaluation of integrated care from a service user perspective.

Item Type: Article
DOI/Identification number: 10.5334/ijic.5504
Uncontrolled keywords: patient reported experience measures, integrated care, older people, person-centredness, care coordination, data quality, methods
Divisions: Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research > Centre for Health Services Studies
Depositing User: Helen Wooldridge
Date Deposited: 16 Jul 2021 10:29 UTC
Last Modified: 19 Jul 2021 09:06 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/89329 (The current URI for this page, for reference purposes)
Gadsby, E.W.: https://orcid.org/0000-0002-4151-5911
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