A standardised and validated patient survey in primary care: introducing the New Zealand General Practice Assessment Questionnaire (NZGPAQ)

Aim To determine whether the New Zealand adaptation of the UK developed General Practice Assessment Questionnaire (GPAQ) is a valid and reliable indicator of the quality of care in general practice in New Zealand and what the survey can tell us about patient satisfaction with general practice. Method The Health Services Consumer Research Ltd Primary Care Patient Survey database which presently contains data from 184 medical practices (549 GPs) and responses from 50,000 enrolled patients was examined to determine the validity and reliability of the survey instrument. Data was briefly analysed to ascertain how survey results can best be employed to improve the quality of primary care. Results A check on representativeness showed that older, female and European patients are over-represented. To determine validity and reliability, the "Cronbach alpha" statistic was calculated and shown to range between 0.85 - 0.96. Convergent validity was demonstrated by high correlations between items that measured closely related aspects of patient care. Discriminant validity was shown by very low correlations between variables that measured unrelated items. Further analyses show how patients' age, sex and ethnic group influence the level of satisfaction experienced. Conclusion The NZGPAQ survey can be employed nationwide to improve the quality of primary care because these patient survey results emphasize where service delivery is good/excellent and identify where change is needed to improve patient satisfaction.