A brief questionnaire for assessing patient healthcare experiences in low-income settings

Tashonna R. Webster, Jeannie Mantopoulos, Elizabeth Jackson, Heather Cole-Lewis, Lillian Kidane, Sosena Kebede, Yigeremu Abebe, Ruth Lawson, Elizabeth H. Bradley

Research output: Contribution to journalArticlepeer-review


Objective: The aim of this study was to develop and to assess the validity and reliability of two brief questionnaires for assessing patient experiences with hospital and outpatient care in a low-income setting. Design: Using literature review and data from focus groups (n = 14), we developed questionnaires to assess patient experiences with inpatient (I-PAHC) and with outpatient (O-PAHC) care in a low-income setting. Questionnaires were administered in person by trained interviewers. Construct validity was assessed with factor analysis; convergent validity was assessed by correlating summary scores for each scale with overall patient evaluations, and reliability was assessed with Cronbach's alpha coefficients. Setting: Eight health facilities in Ethiopia. Participants: Patients >18 years old who had a hospital stay >1 day (n = 230), and patients who received outpatient care (n = 486). Main outcome measures: Patient evaluations of health care experiences. Results: The factor analysis revealed 12 items that loaded on five factors for the I-PAHC questionnaire. The O-PAHC showed similar results with 13 items that loaded on four factors. Summary scores for nearly all factors were significantly associated (P-value < 0.05) with the patient's overall evaluation score. The measure of reliability, Cronbach's alpha coefficients, showed good to excellent internal consistency for all scales. Conclusions: The I-PAHC on O-PAHC questionnaires can be useful in assessing patients' evaluations of care delivery in low-income settings. The questionnaires are brief and can be integrated into health systems strengthening efforts with the support of leadership at the health facility and the country levels.

Original languageEnglish (US)
Article numbermzr019
Pages (from-to)258-268
Number of pages11
JournalInternational Journal for Quality in Health Care
Issue number3
StatePublished - Jun 2011


  • Ethiopia
  • Health system strengthening
  • Low-income country
  • Primary care
  • Quality improvement
  • Validation

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

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