The Chinese Inpatient Experience Scale (CIES) focusing on integrated health care: instrument development and cross-sectional validation study

2024 Prague [Global Evidence Summit]

Du L¹, Feng W², He W³, Zhang W⁴

¹Medical Device Regulatory Research and Evaluation Centre, West China Hospital, Sichuan University, Chengdu, Sichuan, China; West China Biomedical Big Data Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China

²Institute of Hospital Management, West China Hospital of Sichuan University, Chengdu, Sichuan, China; School of Public Health, Sichuan University, Chengdu, Sichuan, China

³Medical Device Regulatory Research and Evaluation Centre, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Institute of Hospital Management, West China Hospital of Sichuan University, Chengdu, Sichuan, China

⁴Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China

Background:

Value-based health care is driving the importance of patient experience metrics in enhancing health care quality and patient value. Nevertheless, there is currently a lack of standardized tools to assess inpatient experience in China.

Objectives:

This study aimed to develop an assessment tool for the inpatient experience, designed to capture patients’ objective observations of the consultation and their general feedback on the process.

Methods:

The study comprised 2 stages: (1) developing the instrument and (2) empirical testing (N = 544). After literature screening and Delphi methods, 8 elements were identified, and a total of 26 preliminary items based on them were designed by entry extraction and screening. Subsequently, a content validity test and a face validity test were carried out, and 23 items were shortlisted. Data were collected in 11 clinical departments of a large tertiary hospital in southwest China. Cronbach's alpha coefficient method and split-half reliability were used to analyze reliability, whereas exploratory and validation factor analysis were used to assess structural validity.

Results:

The Chinese Inpatient Experience Scale (CIES) was developed through exploratory and validated factor analyses. The scale consists of 23 items across 8 factors: "Doctor-patient communication," "Engagement," Privacy," "Right to know," "Services timeliness," "Continuity care," "Visiting environment," and "Overall satisfaction." The cumulative variance explained by these 8 extracted principal components was 92.24%. The content validity was very good (mean item content validity index [I-CVI] = 0.96). Face validity indicated that all items were comprehensible and readable. Confirmatory factor analyses supported the factor structure of the instrument. Internal consistency reliability was found to be acceptable, as indicated by a Cronbach’s alpha of 0.966, odd-even split reliability of 0.983. The 23 corrected items with the raw score summation of the corrected item-total correlations (CITC) ranged from 0.764 to 0.990, and all items met the correlation criteria.

Conclusions:

This study produced a 23-item instrument, which exhibits good psychometric properties. Its use in health care research and clinical practice enables the collection of patient feedback on various aspects of health care delivery during hospitalization. This helps health care providers identify areas for improvement, enhancing the overall patient experience and improving health care quality.