Development and Validation of a Short-Form Safety Net Medical Home Scale

Health Serv Res. 2018 Aug;53 Suppl 1(Suppl Suppl 1):3207-3226. doi: 10.1111/1475-6773.12809. Epub 2017 Dec 1.

Abstract

Objective: To develop a short-form Safety Net Medical Home Scale (SNMHS) for assessing patient-centered medical home (PCMH) capability in safety net clinics.

Data sources/study setting: National surveys of federally qualified health centers (FQHCs). Interviews with FQHC directors.

Study design: We constructed three short-form SNMHS versions and examined correlations with full SNMHS and related primary care assessments. We tested usability with FQHC directors and reviewed scale development with an advisory group.

Data collection: Federally qualified health center surveys were administered in 2009 and 2013, by mail and online. Usability testing was conducted through telephone interviews with FQHC directors in 2013.

Principal findings: Six-, 12-, and 18-question short-form SNMHS versions had Pearson correlations with full scale of 0.84, 0.92, and 0.96, respectively. All versions showed a level of convergent validity with other primary care assessment scales comparable to the full SNMHS. User testers found short forms to be low-burden, though missing some PCMH concepts. Advisory group members expressed caution over missing concepts and appropriate use of short-form self-assessments.

Conclusions: Short-form versions of SNMHS showed strong correlations with full scale and may be useful for brief assessment of safety net PCMH capability. Each short-form SNMHS version may be appropriate for different research, quality improvement, and assessment purposes.

Keywords: Uninsured/safety net providers; primary care; psychometrics.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Humans
  • Patient-Centered Care / organization & administration*
  • Patient-Centered Care / standards
  • Quality of Health Care
  • Reproducibility of Results
  • Residence Characteristics
  • Safety-net Providers / organization & administration*
  • Safety-net Providers / standards
  • Surveys and Questionnaires / standards*