Development and Validation of the Patient Assessment of Chronic Illness Care (PACIC)

TLDR

The study aimed to develop a brief, validated patient self‑report instrument—the 20‑item PACIC—to assess how well chronic illness care aligns with the Chronic Care Model, focusing on patient‑centered, proactive, planned, and collaborative aspects. The authors recruited 283 adults with chronic illness from a large integrated health‑care system, administered the PACIC alongside demographic, patient activation, and primary‑care assessment scales, and used these data to evaluate the instrument’s measurement performance, construct, and concurrent validity. The PACIC showed good internal consistency, moderate test‑retest reliability (r = 0.58 over 3 months), modest correlations with age, gender, and number of conditions, and moderate correlations (r = 0.32–0.60) with primary‑care and patient‑activation measures, confirming its reliability, face, construct, and concurrent validity, and it is publicly available for research and quality improvement.

Abstract

There is a need for a brief, validated patient self-report instrument to assess the extent to which patients with chronic illness receive care that aligns with the Chronic Care Model-measuring care that is patient-centered, proactive, planned and includes collaborative goal setting; problem-solving and follow-up support.A total of 283 adults reporting one or more chronic illness from a large integrated health care delivery system were studied.Participants completed the 20-item Patient Assessment of Chronic Illness Care (PACIC) as well as measures of demographic factors, a patient activation scale, and subscales from a primary care assessment instrument so that we could evaluate measurement performance, construct, and concurrent validity of the PACIC.The PACIC consists of 5 scales and an overall summary score, each having good internal consistency for brief scales. As predicted, the PACIC was only slightly correlated with age and gender, and unrelated to education. Contrary to prediction, it was only slightly correlated (r = 0.13) with number of chronic conditions. The PACIC demonstrated moderate test-retest reliability (r = 0.58 during the course of 3 months) and was correlated moderately, as predicted (r = 0.32-0.60, median = 0.50, P < 0.001) to measures of primary care and patient activation.The PACIC appears to be a practical instrument that is reliable and has face, construct, and concurrent validity. The resulting questionnaire is in the public domain, and recommendations for its use in research and quality improvement are outlined.