# Multi-professional primary healthcare centres: psychometric testing of a new quality-of-care instrument

## TL;DR

This study developed and tested a new questionnaire called QUALSOPRIM to measure the quality of care in multi-professional primary healthcare centers from the patient's perspective.

## Contribution

The study introduces a validated, patient-focused instrument for evaluating multi-professional primary healthcare quality.

## Key findings

- QUALSOPRIM includes five validated domains: HCPs’ availability, medical-technical care, GP expertise, patient-HCP communication, and caregiver role.
- Each domain showed acceptable internal consistency and met psychometric assumptions like unidimensionality and local independence.
- The questionnaire is designed to be short and practical for use in clinical settings.

## Abstract

Currently there is no tool to measure the quality of multi-professional primary healthcare centres (MPHCC) that: (i) includes both the patient perspective and the healthcare professional (HCP) perspective, (ii) explores several aspects of care quality, and (iii) has been validated using advanced psychometric methods. However, it is important that MPHCC quality is evaluated by patients with multimorbidity because they are frequent users and require complex and extensive care. Therefore, the purpose of this study was to construct a questionnaire to allow patients with multimorbidity to measure MPHCC quality.

An item bank of 72 items structured into nine domains was administered to a large sample of patients with multimorbidity, followed at eight rural or semi-rural MPHCCs. The statistical analyses included methods derived from the Classical Test Theory (Cronbach’s alpha > 0.70) and the Item Response Theory (Loevinger’s H > 0.30) to select items/domains and to ensure robust psychometric properties without being too long for patients.

A total of 507 patients were recruited. The statistical analysis of the participants’ responses allowed developing a questionnaire called QUALSOPRIM, that included only five of the nine original domains: “HCPs’ availability”, “Medical-technical care”, “General practitioner’s expertise”, “Patient-HCP relationships and communication”, and “Main informal caregiver’s role in the care pathway”. Each domain had acceptable internal consistency and met the Item Response Theory assumptions (unidimensionality, monotonicity and local independence).

The QUALSOPRIM questionnaire includes five domains that can be used by patients to assess MPHCC quality. Each domain is succinct and can be used also on its own with relative ease in clinical practice. The psychometric results of the QUALSOPRIM questionnaire must be confirmed in an independent sample of patients to establish its external validity.

The online version contains supplementary material available at 10.1186/s41687-026-00995-5.