The Intersectoral Care Reported by Patients (ICRP) survey: a short and simple survey to assess patient perceptions of integrated care

Abstract

Introduction: Several chronic non-communicable diseases share common risk factors.Integration of care is important to ensure the best quality and efficiency of care for patients with multiple conditions. Patients’ perceptions are important for assessing the integration of care. For example,oral and general health are closely related. However, oral and general healthcare often take place in a disintegrated manner. This study aimed to develop a short and simple survey to assess integration of oral and general healthcare through patient perceptions. In addition, the survey was intended to be developed such that it can easily be implemented as an add-on to other surveys. Methods: A literature search was performed to develop a conceptual framework and set of questions for the Intersectoral Care Reported by Patients (ICRP) survey. Thereafter, a modified Delphi-method was used to further elaborate the survey. A panel consisting of seven international experts assessed the survey in three rounds. The experts were based in the United States, Germany, and the Netherlands and had different professional backgrounds including general practice and dentistry. During two interactive discussion rounds and one online round of voting, the framework and the questions were assessed, adapted, and prioritized by the experts. During the online round, the experts were asked to rate the necessity of each question and rank the questions based on importance for inclusion in the ICRP survey. Results: The co-creative development process yielded thirteen questions for inclusion in the ICRP survey. These questions focus on five domains: patients’ wishes, expectations and awareness regarding communication between healthcare providers; patients’ perception of healthcare providers’ knowledge; healthcare provider-patient communication about health status; utilization of healthcare; and self-rated health. Discussion and conclusions: We developed a short, easy-to-understand survey to assess integration of oral and general healthcare as perceived by patients. The survey provides opportunities for usage in research and as a tool in feedback systems for healthcare providers. Lessons learned: During the first group discussion, there were many suggestions for questions, including many differently formatted questions for the same concept. By asking the experts to rate the necessity and rank the questions during the online round, we were able to determine which questions were deemed most apt and relevant for inclusion in the ICRP survey. Limitations: The panel included seven experts, although not all experts were able to participate in all rounds of group conversations. This was solved through individual discussion with some of the experts. Although patients were not involved in the development of the survey, they will soon be involved in usability and understandability testing and piloting of the survey. Suggestions for future research: The survey’s understandability will be assessed by patients. Furthermore, the survey will be tested for usability in real-life practice settings. In order to compare different countries, the survey will be translated to other languages such as Dutch and German.

Keywords

• integrated care
• patient perception
• primary healthcare
• dental healthcare
• survey