Validity and reliability of the Home Health Care Survey of the Consumer Assessment of Healthcare Providers and System (HHCAHPS) tool: a multicentre cross-sectional study

Introduction. This study aims to investigate the psychometric properties of the Home Health Care Survey of the Consumer Assessment of Healthcare Providers and System (HHCAHPS) in the Italian context. Methods. This is a secondary analysis of data from the AIDOMUS- IT study. A total of 9,780 patients cared for by home healthcare services completed the HHCAHPS along with a measure of satisfaction for the care received. Structural validity was assessed with a confirmatory analytical approach (CFA). Construct validity was ascertained via hypothesis testing (convergent validity) by correlating the HHCAHPS scores with the scores derived from the measure of patient satisfaction for care. Internal consistency was assessed with the Omega (ω) coefficient. Results. Structural validity was confirmed, with satisfactory fit indices of the CFA model specified according to the conceptualized three-factor structure (“care of patients”, “communication with the providers”, and “specific care issues”). Construct validity was confirmed with moderate correlations between the level of satisfaction for care and the factors “communication with the providers” (r = 0.39, p < 0.001), “care of patients” (r = 0.34, p < 0.001), and “specific care issues” (r = 0.19, p < 0.001). Internal consistency was satisfactory for the “specific care issues” factor (ω = 0.81), while it was at the threshold of acceptability for the other factors (ω = 0.60-0.62). Conclusions. This study shows that the HHCAHPS is valid and sufficiently reliable when tested on the Italian population. Therefore, this tool can be supportive for promoting research and designing interventions to promote patient-centered care within home healthcare settings.