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Research article
Patients’ Assessment of Care for Type 2 Diabetes: Results of the Patient Assessment of Chronic Illness Care Scale in A Danish Population
Anne Frølich
Kobenhavns Universitet
Corresponding Author
ORCiD: https://orcid.org/0000-0002-0500-9923
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Background: The Patient Assessment of Chronic Illness Care (PACIC) scale is the most appropriate for assessing self-reported experience in chronic care. However, it has yet to be validated in a Danish diabetes population. We aimed to validate the PACIC, assess the quality of care for Danish patients with type 2 diabetes, and identify factors associated with quality of care.
Methods: A survey of 7,745 individuals randomly selected from the National Diabetes Registry. Descriptive statistics inter-item and item-rest correlations and factor analysis assessed the PACIC properties. Quality of care was analysed with descriptive statistics; linear and multiple regression assessed the effect of forty-nine covariates on total and subscale scores.
Results: In total, 2,696 individuals with type 2 diabetes completed ≥ 50% of items. The floor effect for individual items was 8.5-74.5%; the ceiling effect was 4.1- 47.8 %. Cronbach’s alpha was 0.73-0.86 for the five subscales. The comparative fit index (CFI) and the Tucker–Lewis index (TLI) were 0,87, and 0,84, respectively. Mean PACIC score was 2.44 (± 0.04). Respondents receiving rehabilitation and reporting primary of diabetes care had higher total mean scores; those 70 years or older had lower mean total and subscale scores. A higher number of diabetes visits were associated with higher total scores; higher number of emergency department visits were associated with lower total scores. The effect of healthcare utilisation on subscale scores varied.
Conclusions: Floor effects suggest a need for further evaluation of the PACIC questionnaire in Danish settings. Total PACIC scores were lower than in other healthcare systems, possibly being a result of different contexts and cultures, and of a need for improving diabetes care in Denmark.
Keywords
PACIC, Validation, Diabetes Mellitus, Type 2, Patient-Centred Care
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This preprint is under consideration at BMC Health Services Research. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Patients’ Assessment of Care for Type 2 Diabetes: Results of the Patient Assessment of Chronic Illness Care Scale in A Danish Population
Anne Frølich
Kobenhavns Universitet
Corresponding Author
ORCiD: https://orcid.org/0000-0002-0500-9923
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Revision
Version 1
Posted 23 Sep, 2020
No community comments so far
Editorial decision: Major revision
On 29 Dec, 2020
Review #2 received
Received 20 Dec, 2020
Review #3 received
Received 20 Dec, 2020
Review #4 received
Received 17 Dec, 2020
Review #1 received
Received 07 Dec, 2020
Reviewer #4 agreed
On 26 Nov, 2020
Reviewer #3 agreed
On 24 Nov, 2020
Reviewer #2 agreed
On 23 Nov, 2020
Reviewer #1 agreed
On 27 Sep, 2020
Reviewers invited
Invitations sent on 26 Sep, 2020
Submission checks complete
On 21 Sep, 2020
Editor assigned
On 21 Sep, 2020
Editor invited
On 18 Sep, 2020
First submitted
On 21 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The Patient Assessment of Chronic Illness Care (PACIC) scale is the most appropriate for assessing self-reported experience in chronic care. However, it has yet to be validated in a Danish diabetes population. We aimed to validate the PACIC, assess the quality of care for Danish patients with type 2 diabetes, and identify factors associated with quality of care.
Methods: A survey of 7,745 individuals randomly selected from the National Diabetes Registry. Descriptive statistics inter-item and item-rest correlations and factor analysis assessed the PACIC properties. Quality of care was analysed with descriptive statistics; linear and multiple regression assessed the effect of forty-nine covariates on total and subscale scores.
Results: In total, 2,696 individuals with type 2 diabetes completed ≥ 50% of items. The floor effect for individual items was 8.5-74.5%; the ceiling effect was 4.1- 47.8 %. Cronbach’s alpha was 0.73-0.86 for the five subscales. The comparative fit index (CFI) and the Tucker–Lewis index (TLI) were 0,87, and 0,84, respectively. Mean PACIC score was 2.44 (± 0.04). Respondents receiving rehabilitation and reporting primary of diabetes care had higher total mean scores; those 70 years or older had lower mean total and subscale scores. A higher number of diabetes visits were associated with higher total scores; higher number of emergency department visits were associated with lower total scores. The effect of healthcare utilisation on subscale scores varied.
Conclusions: Floor effects suggest a need for further evaluation of the PACIC questionnaire in Danish settings. Total PACIC scores were lower than in other healthcare systems, possibly being a result of different contexts and cultures, and of a need for improving diabetes care in Denmark.
Figure 1