Study Protocol for the Development and Validation of a People Perceived Quality of Health Systems Scale Based on the People's Voice Survey

Abstract

Abstract Background Current research underscores the necessity of assessing the quality of health systems from the people's perspective. The Lancet Global Health Commission has proposed a High-Quality Health System (HQHS) framework, which covers system foundations, care quality, user experience, outcomes, and confidence. The commission has also developed an English version of the People's Voice Survey (PVS) based on the HQHS framework. Lanzhou University has created a Chinese version of PVS. However, the PVS, being a survey, poses challenges in quantifying outcomes. Additionally, its considerable length can limit its usefulness and validity in application. Methods The development and validation of the scale will undergo the following six phases: (1) constructing an initial version of the scale item pool and dimensions based on the existing People's Voice Survey; (2) employing an improved Delphi consultation method to assess the comprehensiveness of the scale items and dimensions in measuring the intended concepts, followed by conducting content validity evaluation; (3) conducting cognitive interviews to explore participants' understanding and difficulties with the items, collecting information to subsequently refine the scale, and enhance face validity; (4) conducting a pilot test to optimize the survey process before the formal validation test; and (5) employing a validation test to assess the scale's test-retest reliability, internal consistency, content validity, face validity, construct validity (including structural validity and hypothesis testing), language and length, following the recommendations of health measurement tool selection guidelines. Discussion This study aims to develop the "People Perceived Quality of Health Systems Scale (PEQSYS)" based on the HQHS and PVS. The PEQSYS will adhere to the rigorous scale development process proposed by COSMIN and PAPERS, among other standards, and aim to possess robust psychometric properties.The anticipated result is a scale possessing essential attributes, including robust psychometric properties, repeatability, quantifiability, and comparability. These characteristics will facilitate a swift and quantitative evaluation of perceived health system quality, ensuring the scale's applicability in diverse contexts.