Validity of self-assessment questionnaire for the quality control of primary health care during the war in Ukraine

Yurii Sich, Pavlo Kolesnyk, Olga Rusanovska

Keywords: primary health care (PHC), quality of medical care, external validity, validation, medical care quality questionnaire

Background:

Ukrainian primary health care(PHC) reformation requires changes in quality control during war. Currently, there is a self-reported quality control questionnaire(SQCQ) developed by UKAID/USAID and recommended by the Ukrainian Health Care Ministry. However some items of this SQCQ may lose their relevance during war. This SQCQ requires revision and adaptation from the perspective of the clinical practices depending on their distance from the frontline.

Research questions:

To determine the validity of the SQCQ by family physicians working in the regions located at a different distance from the frontline.

Method:

The 48-item SQCQ was validated by family doctors who worked far from the frontline (Uzhgorod) and in the regions close to the frontline subject to shelling (Zaporizhzhia, Dnipro, Kharkiv, Kropyvnitsky). 10 doctors assessed the validity of each question on a 5-point scale, together with their comments explaining their point of view. Quantitative analysis of Item Impact Score (IIS) for each question of the SQCQ together with qualitative evaluation of doctors’ comments were performed

Results:

According to the external validation, it was determined that the IIS calculated for all questions was sufficient (>1.5). However, doctors who worked close to the frontline gave lower scores for the certain items of the SQCQ (4,13,18, 19,20,34,48). This fact can either indicate the peculiarities of the quality assessment of these regions or a random subjective vision of the respondents. In order to assess the phenomenon found during our survey, an additional validation survey is planned separately among two groups of doctors living in areas close to and far from the frontline.

Conclusions:

Face validation of all questions of the SQCQ showed high high IIS for each item during wartime. Though some items of the SQCQ differed significantly from the point of view of the doctors who lived close to the frontline which requires clarification

Points for discussion:

Is self-reported quality control questionnaire being used in your country for health care evaluation

Can self-reported quality control questionnaire be used during other crisis then war?

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