Applying confirmatory factor analysis to measure construct validity in health care

Background: Contemporary research on health economics concentrates on measuring efficiency and quality of health care delivery. A lot of studies focus on key performance indicators (KPI) of health care (Loeb, 2004). In accordance with the rules of statistics, before applying any measurement tool, its psychometric properties should be tested. Basically, statisticians concentrate on two properties: scale validity and scale reliability. The validity of a scale provides information on whether a given scale does measure an assumed variable and not a different or similar one. Therefore, scale validity refers to the extent to which an empirical measuring instrument adequately reflects the true significance of a given concept (Welbourne et al., 2017).

Objectives: The purpose of the study is to test scale validity, that can be next applied to measure health care system’ performance. The author focuses on the quality dimension of the health system, which is strongly connected with consumer efficiency in health care.

Data/Methods: The author applied a confirmation factor analysis (CFA). CFA helps to assess the quality of a proposed measurement model for a phenomenon that cannot be directly observed. In our case, it concerns an evaluation of the theoretical validity of the applied set of coefficient variables for individual items of the scale in seven different dimensions of patient service quality. CFA has been conducted on data gathered in a quantitative study (N=320) based on the principal components’ method. The sample was selected randomly.

Results: The research findings let us conclude that the proposed scale has a one-dimensional structure. Validity test of the scale showed that the proposed instrument allows an accurate measurement of the quality of care. This study, thus, contributes to knowledge by developing and empirically examining a measurement tool, helpful in KPI approach.

Policy Implications: The tested tool can be used to assess health care system’s performance in terms of patient service quality and therefore can contribute to assessing consumer efficiency. It can improve the decision making process connected with patient-centered care and strategies that boost consumer efficiency.

Keywords: health care, service quality, scale validation, confirmatory factor analysis (CFA)

References:

T.M. Welbourne, D.E. Johnson, A. Erez, The role-based performance scale: validity analysis of a theory-based measure, Academy of Management Journal 2017, Vol. 41, No. 5.

M.M. Kukaka, A guide to appropriate use of correlation coefficient in medical research, Malawi Medical Journal 2012, Vol. 24, No. 3.