Patient Experiences Questionnaire for Out-of-Hours Care (PEQ-OHC) and EQ-5D-5L: reliability and validity following a national survey

The Patient Experiences Questionnaire for Out-of-Hours Care (PEQ-OHC) is used in local and national surveys of primary care but has not been evaluated for measurement properties since 2010. This study assessed aspects of validity, reliability, and internal consistency alongside the EQ-5D-5L. The PEQ-OHC and EQ-5D-5L were part of an electronic survey of 1,765 OHC patients recruited nationally across Norway 4–8 weeks following care. At 7–12 days, respondents received a retest questionnaire. Testing followed the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist for patient-reported instruments. The 509 (29%) respondents had a median (IQR) age of 55 (38–66) years and 54% were female. Confirmatory factor analysis showed evidence for structural validity including PEQ-OHC scales of doctor contact, nurse contact, organisation and telephone contact (Comparative Fit/Tuckey Lewis Index = 0.97, Standardised Root Mean Residuals = 0.05). Together with a new scale of video contact, Cronbach’s alpha ranged from 0.79–0.98; only organisation fell below 0.90. Test-retest weighted kappa was generally of a high to excellent level for PEQ-OHC items (0.59–0.86) and EQ-5D dimensions (0.76–0.85). Intraclass correlation coefficients ranged from 0.74–0.83 for PEQ-OHC scale scores; EQ-5D-5L index = 0.91, EQ VAS = 0.81. Over 75% of results followed hypotheses, in comparisons of instrument scores with variables relating to experiences, health and services use. Evidence for reliability and validity further supports application of the PEQ-OHC in national and local quality measurement. The EQ-5D-5L also performed well and can be used alongside the PEQ-OHC to assess and adjust for case-mix across OHC centres.