Assessing the maturity of the healthcare system for integrated care: testing measurement properties of the SCIROCCO tool

• Main Authors: Liset Grooten, Hubertus Johannes Maria Vrijhoef, Stefano Calciolari, Laura Guadalupe González Ortiz, Marcela Janečková, Mirella M. N. Minkman, Dirk Devroey
• Format: Article
• Language: English
• Published: BMC 2019-03-01
• Series: BMC Medical Research Methodology
• Subjects: Delivery of health care; Integrated care; Convergent validity; Internal consistency; Maturity; Scaling-up
• Online Access: http://link.springer.com/article/10.1186/s12874-019-0704-1

Abstract Background The Scaling Integrated Care in Context (SCIROCCO) tool has been developed to facilitate knowledge transfer and learning about the implementation and scaling-up of integrated care in European regions. To adequately test the functionality of the tool in assessing the maturity for integrated care within regions, this study evaluated its structural validity, internal consistency and convergent validity. Methods Exploratory factor analysis was used to investigate the structural validity of the 12-items of the SCIROCCO tool. Hereafter, the internal consistency was assessed by calculating Cronbach’s and ordinal alpha. The convergent validity was explored by testing 23 pre-hypothesized relationships between items of the SCIROCCO tool and items of an instrument measuring a similar construct. Results Factor analysis revealed a one-factor structure. Cronbach’s alpha of the overall instrument was 0.92, ordinal alpha was 0.94. Only 30.34% of the hypotheses for testing the convergent validity were met. Conclusion The one-factor structure is considered relevant in representing the structural validity of the SCIROCCO tool. The scale of the SCIROCCO tool shows good internal consistency. The tool (DMIC Quickscan) used to assess the convergent validity might measure a different aspect of integrated care than the SCIROCCO tool. Further research is needed to continue investigating the validity and reliability of the tool.