Quality of care experience- aged care consumers (QCE-ACC) in residential aged care: an assessment of construct validity

Purpose: Providing quality care for older people continues to be a significant challenge globally and in Australia. The Quality-of-Care Experience – Aged Care Consumers (QCE-ACC) has been adopted as a key quality indicator in the national aged care quality indicator program in Australia for public reporting of care quality variation across residential aged care facilities. This study aims to provide further evidence of the construct validity of QCE-ACC among older people living in residential aged care facilities. Methods: Older people (aged > 65 years) receiving residential aged care services participated via face-to-face interview. Participants completed a range of validated instruments, including the QCE-ACC and five additional measures. Feasibility was assessed by examining missing data and floor/ ceiling effects. Construct validity was assessed through two approaches: convergent validity (correlations with other instruments) and known group validity (distinguishing self-rated health and quality of life levels). Internal consistency reliability was measured using Cronbach's alpha (α). Results: Of the 200 respondents (mean age, 85 ± 7.7 years), more than half (n = 113, 56.5%) were over the age of 85 year and 60% (n = 120) were female. The QCE-ACC showed adequate feasibility and demonstrated moderate correlations with the QOL-ACC (ρ = 0.57) and ASCOT (ρ = 0.60). It was also able to differentiate between varying levels of self-reported health and quality of life. The QCE-ACC and its dimensions showed good internal consistency reliability (α = 0.77–0.81). Conclusion: The QCE-ACC demonstrated adequate feasibility, validity and internal consistency to monitor quality of care provided in residential aged care settings.