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Validation of the Rainbow Model of Integrated Care Measurement Tools (RMIC-MTs) in renal care for patient and care providers

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  • Pim P Valentijn
  • Fernando Pereira
  • Christina W Sterner
  • Hubertus J M Vrijhoef
  • Dirk Ruwaard
  • Jörgen Hegbrant
  • Giovanni F M Strippoli

Abstract

Introduction: Integrated service delivery is considered to be an essential condition for improving the management and health outcomes of people with chronic kidney disease (CKD). However, research on the assessment of integrated care by patients and care providers is hindered by the absence of brief, reliable, and valid measurement tools. Objective: The aim of this study was to develop survey instruments for healthcare professionals and patients based on the Rainbow Model of Integrated Care (RMIC), and to evaluate their psychometric properties. Design: The development process was based on the US Food and Drug Administration guidelines. This included item generation from systematic reviews of existing tools and expert opinion on clarity and content validity, involving renal care providers and chronic kidney patients. A cross-sectional, multi-centre design was used to test for internal consistency and construct validity. Setting: Outpatient clinics in a large renal network. Participants: A sample of 30.788 CKD patients, and 8.914 renal care providers. Methods and analysis: Both survey instruments were developed using previous qualitative work and published literature. A multidisciplinary expert panel assessed the face and content validity of both instruments and following a pilot study, the psychometric properties of both instruments were explored. Exploratory factor analysis with principal axis factoring and with promax rotation was used to assess the underlying dimensions of both instruments; Cronbach’s alpha was used to determine the internal constancy reliability. Results: 17.512 patients (response rate: 56.9%) and 8.849 care providers (response rate: 69.5%) responded to the questionnaires. Factor analysis of the patient questionnaire yielded three internally consistent (Cronbach’s alpha > 0.7) factors: person-centeredness, clinical coordination, and professional coordination. Factor analysis of the provider questionnaire produced eight internally consistent (Cronbach’s alpha > 0.7) factors: person-centeredness, community centeredness, clinical coordination, professional coordination, organisational coordination, system coordination, technical and cultural competence. As hypothesised, care coordination patient and providers scores significantly correlated with questions about quality of care, treatment involvement, reported health, clinics’ organisational readiness, and external care coordination capacity. Conclusion: This study provides evidence for the reliability and validity of the RMIC patient and provider questionnaires as generic tools to assess the experience with or perception of integrated renal care delivery. The instruments are recommended in future applications testing test-retest reliability, convergent and predictive validity, and responsiveness.

Suggested Citation

  • Pim P Valentijn & Fernando Pereira & Christina W Sterner & Hubertus J M Vrijhoef & Dirk Ruwaard & Jörgen Hegbrant & Giovanni F M Strippoli, 2019. "Validation of the Rainbow Model of Integrated Care Measurement Tools (RMIC-MTs) in renal care for patient and care providers," PLOS ONE, Public Library of Science, vol. 14(9), pages 1-21, September.
    • Handle: RePEc:plo:pone00:0222593
    DOI: 10.1371/journal.pone.0222593
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    References listed on IDEAS

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    1. Wensing, Michel & Grol, Richard & Smits, Anton, 1994. "Quality judgements by patients on general practice care: A literature analysis," Social Science & Medicine, Elsevier, vol. 38(1), pages 45-53, January.
    2. Nathan R Hill & Samuel T Fatoba & Jason L Oke & Jennifer A Hirst & Christopher A O’Callaghan & Daniel S Lasserson & F D Richard Hobbs, 2016. "Global Prevalence of Chronic Kidney Disease – A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-18, July.
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    1. Colombani, Françoise & Encrenaz, Gaëlle & Sibé, Matthieu & Quintard, Bruno & Ravaud, Alain & Saillour-Glénisson, Florence, 2022. "Development of an evidence-based reference framework for care coordination with a focus on the micro level of integrated care: A mixed method design study combining scoping review of reviews and nomin," Health Policy, Elsevier, vol. 126(3), pages 245-261.
    2. Roberto Latina & Katia Salomone & Daniela D’Angelo & Daniela Coclite & Greta Castellini & Silvia Gianola & Alice Fauci & Antonello Napoletano & Laura Iacorossi & Primiano Iannone, 2020. "Towards a New System for the Assessment of the Quality in Care Pathways: An Overview of Systematic Reviews," IJERPH, MDPI, vol. 17(22), pages 1-16, November.

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