Cross-Cultural Validation of the Patient Perception of Integrated Care Survey

Maike V. Tietschert*, Federica Angeli, Arno J.A. van Raak, Dirk Ruwaard, Sara J. Singer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objective: To test the cross-cultural validity of the U.S. Patient Perception of Integrated Care (PPIC) Survey in a Dutch sample using a standardized procedure. Data Sources: Primary data collected from patients of five primary care centers in the south of the Netherlands, through survey research from 2014 to 2015. Study Design: Cross-sectional data collected from patients who saw multiple health care providers during 6 months preceding data collection. Data collection: The PPIC survey includes 59 questions that measure patient perceived care integration across providers, settings, and time. Data analysis followed a standardized procedure guiding data preparation, psychometric analysis, and included invariance testing with the U.S. dataset. Principal Findings: Latent scale structures of the Dutch and U.S. survey were highly comparable. Factor “Integration with specialist” had lower reliability scores and noninvariance. For the remaining factors, internal consistency and invariance estimates were strong. Conclusions: The standardized cross-cultural validation procedure produced strong support for comparable psychometric characteristics of the Dutch and U.S. surveys. Future research should examine the usability of the proposed procedure for contexts with greater cultural differences.

Original languageEnglish
Pages (from-to)1745-1776
Number of pages32
JournalHealth services research
Issue number3
Publication statusPublished - 1 Jun 2018


  • Cross-cultural validation
  • health system outcome measures
  • Patient Perception of Integrated Care Survey
  • standardization

Cite this