Patient reported hospital quality (PRHQ): Scale development, reliability, and validity

Objectives: The purpose of this study was to develop and test the reliability and validity of the Patient Reported Hospital Quality (PRHQ) Scale. Methods: 2,675 discharged patients across 20 hospitals in Taiwan were used in the current survey. Core items of the PRHQ were selected by the process of item analysis. Reliability was then examined by conducting Cronbach's alpha and split-half reliability tests. Validity analyses including content validity, criterion-related validity, and construct validity were tested by applying Pearson's correlation coefficient, Exploratory Factor Analysis (EFA), and Confirmatory Factor Analysis (CFA). Results: Through the process of item analysis, the original questionnaire was revised to include 27 core items, which were defined by six domains: medical care, nursing care, overall interaction, respect, psychosocial support, and hospital environment. The internal consistency (Cronbach's alpha) coefficients and the splithalf reliability coefficients were 0.72 to 0.89 and 0.64 to 0.86 at the domain levels, showing good reliability of the scale. In addition, the range of the correlations between items and their domain scores was 0.57 to 0.88 (p<0.01), showing good content validity. The range of the correlations between domain scores and the criterion item was 0.41 to 0.58, indicating adequate criterionrelated validity. Results from EFA indicated that among the six hypothetical domains, overall interaction, respect, and psychosocial support could be integrated into one factor; however, CFA of the six-factor model showed it to be the best fit for the data, indicating good construct validity for the PRHQ. Conclusions: The first version of the PRHQ was confirmed to be reliable and valid and it can be applied in future studies to enrich the existing system for evaluation of hospital quality.