Public perceptions of key performance indicators of healthcare in Alberta, Canada.

OBJECTIVE To examine the relationship between public perceptions of key performance indicators assessing various aspects of the health-care system. DESIGN Cross-sequential survey research. Annual telephone surveys of random samples of adult Albertans selected by random digit dialing and stratified according to age, sex and region (n = 4000 for each survey year). The survey questionnaires included single-item measures of key performance indicators to assess public perceptions of availability, accessibility, quality, outcome and satisfaction with healthcare. Cronbach's α and factor analysis were used to assess the relationship between key performance indicators focusing on the health-care system overall and on a recent interaction with the health-care system. SETTING The province of Alberta, Canada during the years 1996-2004. PARTICIPANTS Four thousand adults randomly selected each survey year. MAIN OUTCOME MEASURE(S) Survey questions measuring public perceptions of healthcare availability, accessibility, quality, outcome and satisfaction with healthcare. RESULTS Factor analysis identified two principal components with key performance indicators focusing on the health system overall loading most strongly on the first component and key performance indicators focusing on the most recent health-care encounter loading most strongly on the second component. Assessments of the quality of care most recently received, accessibility of that care and perceived outcome of care tended to be higher than the more general assessments of overall health system quality and accessibility. CONCLUSION Assessments of specific health-care encounters and more general assessments of the overall health-care system, while related, nevertheless comprise separate dimensions for health-care evaluation.