Piloting a generic cancer consumer quality index for cancer patients in European countries

Background: Across health care systems, patient satisfaction has become an increasing concern over the past decades. Based on the Consumer Quality Index method(founded on Consumer Assessment of Healthcare Providers and Systems) a questionnaire was recently developed for Dutch cancer patients. As a next step, this study aimed to adapt and pilot this questionnaire for international comparison of cancer patients experience and satisfaction with care in 6 European countries; the European Cancer Consumer Quality Index (ECCQI). Methods: Firstly an already existing CQI for cancer patients was adapted for international use. A minimum of 100 patients per site were surveyed through convenience sampling. The CQI was translated into the local language at the participating pilot sites using cross-translation. Data from 7 pilot sites in 6 countries was collected through an online and paper based survey and analyzed with SPSS. Reliability was tested by calculating Cronbach’s alpha and validity by means of cognitive interviews. To measure whether the level of patient activation was a confounding factor, the Patient Activation Measure (PAM) was used. In order to examine to what extent the results of the ECCQI pilot are influenced by national cultural an explorative study using Hofstede’s cultural dimensions theory was applied. Demographic factors were compared as possible con-founders. Results: A total of 685 patients from six European countries filled the questionnaire. Cronbach’s alpha was good or satisfactory in 8 out of 10 categories. Patient satisfaction was scored very similar between the countries (3.27 – 3.46 on a scale from 1 to 4). Age, gender and level of activation were factors that had an influence on the outcomes as well as cultural differences. The results of the PAM show that respondents with a high level of activation have a tendency to score higher. Conclusions: This European Cancer Consumer Quality Index showed promising scores on reliability and a good internal validity. The ECCQI is up to our knowledge the first to measure and compare experiences and satisfaction of cancer patients on an international level. This ECCQI may enable healthcare providers to improve the quality of cancer care.