Patients’ Perspectives on Determinants Avoidable Hospitalizations: Development and Validation of a Questionnaire

João Sarmento,António Panarra,Rodrigo Feteira-Santos,Ana Catarina Rodrigues,Rui Santana,Paula Nascimento,Margarida Siopa,António Sousa Guerreiro,Sílvia Lopes,Afonso Rodrigues,Sónia Dias,João Victor Rocha

doi:10.3390/ijerph19053138

Abstract

Ambulatory care sensitive conditions (ACSC) can be avoided through effective care in the ambulatory setting. Patients are the most qualified individuals to express the social and individual contexts of their own experience. Thus, understanding why potentially preventable hospitalizations occur is important to develop patient-centred policies or interventions that may reduce them. This study aims to develop and validate a questionnaire to capture the patients’ perspective on the causes of the hospitalizations for ACSC. The development of a new questionnaire involved four phases: a literature review, face validity, pre-test, and validation. We conducted a three-step face validity verification to confirm the relevance of the identified determinants and to collect determinants not previously identified by interviewing healthcare providers, representatives of patients’ associations, and patients. Determinants were identified through the literature review predominantly in the “Healthcare Access”, “Disease self-management”, and “Social Support” domains. The validated resulting questionnaire comprises 25 questions, distributed by two dimensions (individual/contextual) covering seven domains and 20 determinants of ACSC hospitalization. Currently, there are no validated instruments as comprehensive and easy to use as the one described in this paper. This questionnaire should provide a base for further language/context validations.

Highlights

Patients are the most qualified individuals to express the social and individual contexts of their own experience
Four papers used the patients’ perspective [1–3,17], two the professionals’ perspective [4,16], and one used a population-based approach using an administrative database to predict the individual risk of Ambulatory care sensitive conditions (ACSC) hospitalization [5]
Our literature review identified several determinants of ACSC hospitalizations aggregated into domains and dimensions

Summary

Introduction

Patients are the most qualified individuals to express the social and individual contexts of their own experience. They should be an important source of information, providing a more holistic and long-term view of the factors that contribute to hospitalizations. If patient-centred care is advocated, the patients’ point of view needs to be included in the research process to centre outcomes to their interests and values [1,2].

Objectives

Results

Conclusion