Psychometric Properties of the Access of Older Adults to Outpatient Primary-Care Health Services Scale.

ABSTRACT

This study evaluates the psychometric properties of the Access of Older Adults to Outpatient Primary-Care Health Services Scale (AOAOPHSS), in research conducted among 707 Mexican older adults selected by convenience from 14 rural and one urban locations. The AOAOPHSS explores 10 dimensions of two integrated subscales Accessibility and Personal Abilities. Data analysis was performed in five phases. First, potentially biased responses were identified. Second, the response efficiency of the items and their association with external variables were evaluated. Third, the basic properties of the scores for the subscales' dimensions of the AOAOPHSS were identified using non-parametric Mokken Scaling Analysis (MSA). Fourth, the Structural Equation Modeling methodology was used to identify the properties of the internal structure of the latent construct. Finally, reliability and internal consistency were evaluated at both score and item levels. The following findings emerged. 13 items with inefficient response options were removed, and 24 were retained using the MSA. The latent structure of the latter was defined based on 21 items of five Accessibility Subscale dimensions. Its internal consistency reliability ranged between 0.67 and 0.81 (omega coefficients) and between 0.61 and 0.78 (alpha coefficients). Accordingly, this paper discusses the overall implications of using the Accessibility Subscale.