Open Access Research article

The Chinese-version of the CARE Measure reliably differentiates between doctors in primary care: a cross-sectional study in Hong Kong

Stewart W Mercer1*, Colman SC Fung2, Frank WK Chan2, Fiona YY Wong2, Samuel YS Wong2 and Douglas Murphy3

Author Affiliations

1 Primary Care Research, General Practice and Primary Care, University of Glasgow, Glasgow, Scotland, UK

2 School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong

3 Quality, Safety and Informatics Research Group, Division of Clinical and Population Sciences and Education, University of Dundee, Dundee, Scotland, UK

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BMC Family Practice 2011, 12:43  doi:10.1186/1471-2296-12-43

Published: 1 June 2011



The Consultation and Relational Empathy (CARE) Measure is a widely used patient-rated experience measure which has recently been translated into Chinese and has undergone preliminary qualitative and quantitative validation. The objective of this study was to determine the reliability of the Chinese-version of the CARE Measure in reliably differentiating between doctors in a primary care setting in Hong Kong


Data were collected from 984 primary care patients attending 20 doctors with differing levels of training in family medicine in 5 public clinics in Hong Kong. The acceptability of the Chinese-CARE measure to patients was assessed. The reliability of the measure in discriminating effectively between doctors was analysed by Generalisability-theory (G-Theory)


The items in the Chinese-CARE measure were regarded as important by patients and there were few 'not applicable' responses. The measure showed high internal reliability (coefficient 0.95) and effectively differentiated between doctors with only 15-20 patient ratings per doctor (inter-rater reliability > 0.8). Doctors' mean CARE measure scores varied widely, ranging from 24.1 to 45.9 (maximum possible score 50) with a mean of 34.6. CARE Measure scores were positively correlated with level of training in family medicine (Spearman's rho 0.493, p < 0.05).


These data demonstrate the acceptability, feasibility and reliability of using the Chinese-CARE Measure in primary care in Hong Kong to differentiate between doctors interpersonal competencies. Training in family medicine appears to enhance these key interpersonal skills.

CARE Measure; reliability; consultations; empathy; Hong Kong China; primary care