• Alicia O'Cathain, Emma Knowles, and Jon Nicholl.
• Medical Care Research Unit, ScHARR, University of Sheffield, Regent Street, Sheffield S1 4DA, UK. a.ocathain@sheffield.ac.uk
• BMJ Qual Saf. 2011 Feb 1; 20 (2): 134-40.

BackgroundPatients seeking emergency and urgent care tend to experience a system, making choices about which service to use and making use of a number of services within a healthcare episode. The aim was to psychometrically test the Urgent Care System Questionnaire (UCSQ) for the routine measurement of the patient perspective of the emergency and urgent care system.MethodsThe UCSQ was developed based on qualitative research with recent users of the system. It consisted of a screening question to identify recent users and questions on the patient experience of, and satisfaction with, their most recent event. The acceptability, validity and reliability of the UCSQ were tested in a postal survey of 900 members of the general population and a telephone survey of a quota sample of 1000 members of the general population.ResultsThe response rate to the postal survey was 51% (457/893). In the telephone survey, 11604 calls were made to obtain a quota sample of 1014 people. These surveys identified 250 system users in the previous 3 months. A principal-components analysis identified three satisfaction components with good internal consistency (Cronbach alpha between 0.7 and 0.93): 'progress through the system' (10 items), 'entry into the system' (three items) and 'patient convenience' (five items). These components varied as expected by age and overall rating of the system.ConclusionPreliminary testing suggests that the UCSQ has reasonable acceptability, validity and reliability. Further testing is required, particularly its responsiveness to changes in emergency and urgent care systems.

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