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Evaluating the Structure of the Patient Assessment of Chronic Illness Care (PACIC) Survey from the Patient’s Perspective

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

The Patient Assessment of Chronic Illness Care (PACIC) survey is a widely used instrument to assess the patient experience with healthcare delivery.

Purpose

This study aims to evaluate the factorial structure of PACIC from the patient perspective.

Methods

A postal survey was mailed to 4,796 randomly selected adults with diabetes from 34 primary care clinics. Internal consistencies of PACIC subscales were assessed by Cronhach’s α. Factorial structure was evaluated by confirmatory and exploratory factor analyses.

Results

Based on responses of 2,055 patients (43 % response rate), exploratory factor analysis discerned a 4-factor, not 5-factor, model dominated by patient evaluation of healthcare services (explaining 74 % of the variance). The other 3 factors addressed patient involvement (goal setting, participating in the healthcare team) and social support for self-management.

Conclusions

The underlying factorial structure of PACIC, which reflects the patient perspective, is dynamic, patient-centered, and differs from the original 5-factor model that was more aligned with views of healthcare delivery stakeholders.

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References

  1. Alwan A, MacLean DR, Riley LM, et al. Monitoring and surveillance of chronic non-communicable diseases: Progress and capacity in high-burden countries. Lancet. 2010; 376: 1861-1868.

    Article  PubMed  Google Scholar 

  2. Global status report on noncommunicable diseases 2010. Geneva, Switzerland: World Health Organization, 2011, 9–16.

  3. Zhang P, Zhang X, Brown J, et al. Global healthcare expenditure on diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010; 87: 293-301.

    Article  PubMed  Google Scholar 

  4. Chronic Diseases and Health Promotion. Retrieved 08/05/2013, from http://www.cdc.gov/chronicdisease/overview/index.htm#ref1

  5. Wagner EH. Chronic disease management: What will it take to improve care for chronic illness? Eff Clin Pract ECP. 1998; 1: 2-4.

    CAS  Google Scholar 

  6. Wagner EH, Austin BT, Davis C, et al. Improving chronic illness care: Translating evidence into action. Health Aff. 2001; 20: 64-78.

    Article  CAS  Google Scholar 

  7. Glasgow RE, Wagner EH, Schaefer J, et al. Development and validation of the Patient Assessment of Chronic Illness Care (PACIC). Med Care. 2005; 43: 436-444.

    Article  PubMed  Google Scholar 

  8. Bonomi AE, Wagner EH, Glasgow RE, VonKorff M. Assessment of Chronic Illness Care (ACIC): A practical tool to measure quality improvement. Health Serv Res. 2002; 37: 791-820.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Glasgow RE, Whitesides H, Nelson CC, King DK. Use of the Patient Assessment of Chronic Illness Care (PACIC) with diabetic patients: Relationship to patient characteristics, receipt of care, and self-management. Diabetes Care. 2005; 28: 2655-2661.

    Article  PubMed  Google Scholar 

  10. Maindal HT, Sokolowski I, Vedsted P. Adaptation, data quality and confirmatory factor analysis of the Danish version of the PACIC questionnaire. Eur J Pub Health. 2012; 22: 31-36.

    Article  Google Scholar 

  11. Rosemann T, Laux G, Droesemeyer S, Gensichen J, Szecsenyi J. Evaluation of a culturally adapted German version of the Patient Assessment of Chronic Illness Care (PACIC 5A) questionnaire in a sample of osteoarthritis patients. J Eval Clin Pract. 2007; 13: 806-813.

    Article  PubMed  Google Scholar 

  12. Schmittdiel J, Mosen DM, Glasgow RE, et al. Patient Assessment of Chronic Illness Care (PACIC) and improved patient-centered outcomes for chronic conditions. J Gen Intern Med. 2008; 23: 77-80.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Taggart J, Chan B, Jayasinghe UW, et al. Patients Assessment of Chronic Illness Care (PACIC) in two Australian studies: Structure and utility. J Eval Clin Pract. 2011; 17: 215-221.

    Article  PubMed  Google Scholar 

  14. Wensing M, van Lieshout J, Jung HP, Hermsen J, Rosemann T. The Patients Assessment Chronic Illness Care (PACIC) questionnaire in The Netherlands: a validation study in rural general practice. BMC Health Serv Res. 2008; 8: 182.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Aragones A, Schaefer EW, Stevens D, et al. Validation of the Spanish translation of the Patient Assessment of Chronic Illness Care (PACIC) survey. Preventing Chronic Dis. 2008; 5: A113.

    Google Scholar 

  16. Cramm JM, Nieboer AP. Factorial validation of the Patient Assessment of Chronic Illness Care (PACIC) and PACIC short version (PACIC-S) among cardiovascular disease patients in the Netherlands. Health Qual Life Outcome. 2012; 10: 104.

    Article  Google Scholar 

  17. Rick J, Rowe K, Hann M, et al. Psychometric properties of the Patient Assessment of Chronic Illness Care measure: Acceptability, reliability and validity in United Kingdom patients with long-term conditions. BMC Health Serv Res. 2012; 12: 293.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Goetz K, Freund T, Gensichen J, et al. Adaptation and psychometric properties of the PACIC short form. Am J Manag Care. 2012; 18: e55-e60.

    PubMed  Google Scholar 

  19. Drewes HW, de Jong-van Til JT, Struijs JN, et al. Measuring chronic care management experience of patients with diabetes: PACIC and PACIC+ validation. Int J Integr Care. 2012; 12: e194.

    PubMed Central  PubMed  Google Scholar 

  20. Spicer J, Budge C, Carryer J. Taking the PACIC back to basics: The structure of the Patient Assessment of Chronic Illness Care. J Eval Clin Pract. 2012; 18: 307-312.

    Article  PubMed  Google Scholar 

  21. Gugiu C, Coryn CL, Applegate B. Structure and measurement properties of the Patient Assessment of Chronic Illness Care instrument. J Eval Clin Pract. 2010; 16: 509-516.

    PubMed  Google Scholar 

  22. Hu LT, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equ Model Multidiscip J. 1999; 6: 1-55.

    Article  Google Scholar 

  23. Asch DA, Jedrziewski MK, Christakis NA. Response rates to mail surveys published in medical journals. J Clin Epidemiol. 1997; 50: 1129-1136.

    Article  CAS  PubMed  Google Scholar 

  24. Curtin R, Presser S, Singer E. Changes in telephone survey nonresponse over the past quarter century. Publ Opin Q. 2005; 69: 87-98.

    Article  Google Scholar 

  25. Groves RM. Nonresponse rates and nonresponse bias in household surveys. Publ Opin Q. 2006; 70: 646-675.

    Article  Google Scholar 

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Acknowledgments

Funding was provided by a grant from the Mayo Health System Practice-Based Research Network. Dr. Shah was supported in part by grant UL1RR024150 from the National Center for Advancing Translational Sciences (NCATs).

Authors’ Statement of Conflict of Interest and Adherence to Ethical Standards

Authors Jiaquan Fan, Rozalina G. McCoy, Jeanette Y. Ziegenfuss, Steven A. Smith, Bijan J. Borah, James R. Deming, Victor M. Montori, and Nilay D. Shah declare that they have no conflict of interest. All procedures were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

Author information

Authors and Affiliations

  1. Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, 200 First Street SW., Rochester, MN, 55905, USA

    Jiaquan Fan PhD, Steven A. Smith MD, Bijan J. Borah PhD & Nilay D. Shah PhD

  2. Division of Endocrinology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA

    Rozalina G. McCoy MD, Steven A. Smith MD & Victor M. Montori MD

  3. HealthPartners Institute for Education and Research, Bloomington, MN, USA

    Jeanette Y. Ziegenfuss PhD

  4. Department of Family Medicine, Mayo Clinic Health System-Franciscan Healthcare, Tomah, WI, USA

    James R. Deming MD

Authors
  1. Jiaquan Fan PhD
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  2. Rozalina G. McCoy MD
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  3. Jeanette Y. Ziegenfuss PhD
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  4. Steven A. Smith MD
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  5. Bijan J. Borah PhD
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  6. James R. Deming MD
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  7. Victor M. Montori MD
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  8. Nilay D. Shah PhD
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Corresponding author

Correspondence to Nilay D. Shah PhD.

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Fan, J., McCoy, R.G., Ziegenfuss, J.Y. et al. Evaluating the Structure of the Patient Assessment of Chronic Illness Care (PACIC) Survey from the Patient’s Perspective. ann. behav. med. 49, 104–111 (2015). https://doi.org/10.1007/s12160-014-9638-3

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  • DOI: https://doi.org/10.1007/s12160-014-9638-3

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