Measuring continuity of care for cardiac patients: development of a patient self-report questionnaire.

Background: Continuity of care can be a challenge for cardiac patients, many of whom require chronic and complex management from a variety of health care personnel in multiple settings. For health services research, measures are needed that encompass the multifaceted nature of continuity of care for cardiac patients.
Objective: To assess continuity of care from the patient's perspective, a comprehensive self-report instrument of continuity of care for patients with congestive heart failure and atrial fibrillation was developed and validated.
Methods: Based on published work, patient interviews and provider input, the Heart Continuity of Care Questionnaire (HCCQ) was developed to assess various aspects of care in the transition from hospital to home. The HCCQ covered a variety of content areas relevant to cardiac care. The HCCQ and either the Continuity of Care Index (CCI) or the Minnesota Living with Heart Failure Questionnaire (MLHFQ) were completed by 83 patients who had been discharged for at least six months.
Results: Most items had good response rates. The subscales, defined a priori, had good reliability (subscales alpha ranged from 0.80 to 0.93). The HCCQ and its subscales had strong correlations with the CCI but not the MLHFQ. The HCCQ subscales demonstrated better known group validity than the CCI.
Conclusions: In this preliminary study, the HCCQ appears to be a comprehensive, reliable and valid measure of continuity of care from the patient perspective. Further studies of the validity, generalizability and use are needed.