Department of Family & Community Medicine, University of California, San Francisco, 1001 Potrero Ave, San Francisco, CA 94110, USA.
National Family Planning and Reproductive Health Association, 1025 Vermont Ave. NW, Suite 800, Washington, DC 20005, USA.
Contraception. 2023 Jul;123:110010. doi: 10.1016/j.contraception.2023.110010. Epub 2023 Mar 17.
A performance measure assessing how often patients experience patient-centered contraceptive counseling can inform quality improvement in contraceptive care and enable efforts to enhance equity in the provision of this care. We sought to test the validity and reliability of the Person-Centered Contraceptive Counseling (PCCC) measure as a performance measure, in preparation for application for endorsement from the National Quality Forum.
We combined data from two research studies, a statewide quality improvement assessment, and a dedicated data collection effort at nine sites, all collected between 2009 and 2019 at 22 total sites in the United States, to evaluate the validity and reliability of the four-item PCCC measure aggregated at the provider and facility level. We scored the PCCC dichotomously as a "top-box" score of 20 versus less than 20. We assessed reliability using the Spearman-Brown coefficient, and validity by comparing scores on the PCCC to aggregated scores on single-item measures of patient satisfaction.
We included 22 facilities and 34 providers in the analyses. The average PCCC top-box score by provider and facility was 81% and 79%, respectively. We found adequate reliability with panel sizes of 20-50. PCCC scores were strongly associated with the single-item measures of satisfaction. There were notable disparities by race/ethnicity and language (Spanish vs English) in PCCC scores.
The PCCC is a valid and reliable performance measure for use at the provider and facility level. The development and use of the measures of patient experience, like the PCCC, is critical for prioritizing patient-centeredness in reproductive health care.
The PCCC measure can facilitate the identification of gaps and disparities in patient-centered contraceptive counseling and enable quality improvement to promote quality, equitable contraceptive care. Using this measure provides the opportunity to enhance patient experience of care and build trust between contraceptive providers and the communities they serve.
评估患者接受以患者为中心的避孕咨询频率的绩效指标可以为避孕护理质量改进提供信息，并有助于努力增强提供这种护理的公平性。我们旨在测试以患者为中心的避孕咨询（PCCC）作为绩效指标的有效性和可靠性，为该指标获得国家质量论坛认可做准备。
我们结合了两项研究的数据、一项全州范围的质量改进评估以及在九个地点进行的专门数据收集工作，这些数据均于 2009 年至 2019 年在美国 22 个总共的地点收集，以评估聚合在提供者和医疗机构层面的四项 PCCC 指标的有效性和可靠性。我们将 PCCC 指标进行二分法评分，20 分或以上为“高分”，低于 20 分为“低分”。我们使用斯皮尔曼-布朗系数评估可靠性，通过将 PCCC 得分与单项患者满意度指标的得分进行比较来评估有效性。
我们纳入了 22 个设施和 34 名提供者进行分析。每个提供者和医疗机构的平均 PCCC 高分率分别为 81%和 79%。我们发现，当小组规模为 20-50 时，可靠性适中。PCCC 得分与单项满意度指标密切相关。PCCC 得分在种族/民族和语言（西班牙语与英语）方面存在显著差异。
PCCC 是一种在提供者和医疗机构层面使用的有效且可靠的绩效指标。患者体验指标（如 PCCC）的开发和使用对于将以患者为中心的理念放在生殖健康护理的首位至关重要。
PCCC 测量方法可有助于确定以患者为中心的避孕咨询方面的差距和差异，并能够促进质量改进，以提高优质、公平的避孕护理。使用该指标有机会改善患者的护理体验，并在避孕提供者和他们所服务的社区之间建立信任。
