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Item non-respons bij CQI onderzoek onder patiënten van allochtone herkomst

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Samenvatting

Achtergrond: Bij de ontwikkeling van de CQ-index methodiek is nog niet onderzocht hoe valide deze Nederlandse meetinstrumenten zijn wanneer deze gebruikt worden bij allochtone respondenten. Om een inschatting te maken van de validiteit van de CQI ziekenhuiszorg is onderzocht of er verschillen zijn in de mate waarin de kernvragen van het meetinstrument compleet ingevuld zijn, de zogenoemde item non-respons, tussen respondenten van verschillende etnische groepen en wat de oorzaken daarvoor zijn. Methode: Om de invloed van etnische herkomst te bepalen op de item non-respons zijn multilevel lineaire regressie analyses uitgevoerd op de data van 23058 ingevulde CQI ziekenhuiszorg vragenlijsten. Er is gekeken of een eventueel effect verklaard kon worden door leesvaardigheid of opleiding. Resultaten: Er bleek een verband te zijn tussen etnische herkomst en item non-respons. De item non-respons bleek hoger voor Turkse, Marokkaanse en overige niet-westerse patiënten. Dit kon alleen bij Marokkaanse respondenten verklaard worden door opleiding en leesvaardigheid. Discussie: Door de hogere item non-respons onder allochtone respondenten op sommige onderwerpen van de CQI ziekenhuiszorg is de data kwaliteit voor deze respondenten lager. Waarschijnlijk veroorzaken andere factoren dan leesvaardigheid of opleiding dit, hoewel discutabel is of leesvaardigheid via een schriftelijke vraag vastgesteld kan worden. Verder onderzoek naar de invloed van culturele achtergrond op data-kwaliteit en uitkomsten uit CQ-index onderzoek is gewenst, evenals non-respons onderzoek om de representativiteit van allochtone respondenten in de steekproef te bepalen.

Abstract

Item non-response for ethnic minorities in CQ research Background: The development of consumer experience measures (the so-called consumer quality index or CQ-index) in The Netherlands has not taken into account the data quality, instrument reliability and validity among ethnic minorities. To estimate the quality of data for these groups, ethnic differences in item non-response were assessed. Possible explanations for any ethnic differences were explored. Method: To measure the impact of ethnic background on possible differences in item non-response, multilevel linear regression models were fit to the data of 23058 respondents who filled out the hospital version of CQ-index. The association of ethnicity with overall percentage of non-response on core items was explored, while accounting for the possible explanatory effects of education and Dutch language reading proficiency. Results: There were ethnic differences in item non-response, with item non-response being higher for the Turkish, Moroccan and other non-western ethnic minorities. This effect could only be explained by their education and Dutch language reading proficiency for Moroccan respondents. Discussion: Higher item non-response for ethnic minorities on core aspects of the hospital CQ index results in lower data quality for these respondents. This is probably explained by unmeasured factors, although measuring respondents’ Dutch language proficiency through a written question in Dutch is problematic. Further research into these and related issues should include thorough cognitive testing and extensive response analysis to ensure the reliability, validity and usability of the CQ-index among multi-ethnic groups in the Netherlands.

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    Bastiaan Roset

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  1. Bastiaan Roset
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  2. Karien Stronks
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  3. Herman Sixma
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  4. Jany Rademakers
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  5. Onyebuchi Arah
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Correspondence to Bastiaan Roset.

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Afdeling Sociale Geneeskunde, Academisch Medisch Centrum, Universiteit van Amsterdam, Amsterdam

Afdeling Sociale Geneeskunde, Academisch Medisch Centrum, Universiteit van Amsterdam, Amsterdam

Nederlands instituut voor onderzoek van de gezondheidszorg, NIVEL, Utrecht

Nederlands instituut voor onderzoek van de gezondheidszorg, NIVEL, Utrecht

Afdeling Sociale Geneeskunde, Academisch Medisch Centrum, Universiteit van Amsterdam, Amsterdam

Department of Epidemiology, University of California, Los Angeles (UCLA), School of Public Health, Los Angeles, California, United States

Bastiaan Roset, Afdeling Sociale Geneeskunde, AMC / UvA, Postbus 22660, 1100 DD Amsterdam

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Roset, B., Stronks, K., Sixma, H. et al. Item non-respons bij CQI onderzoek onder patiënten van allochtone herkomst. TVGW 86, 471–477 (2008). https://doi.org/10.1007/BF03082145

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