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PEDIATRICS Vol. 105 No. 4 Supplement April 2000, pp. 998-1003

Measuring Consumer Experiences With Primary Care

Received May 26, 1999; accepted Nov 12, 1999.

Charlyn E. Cassady*, Barbara Starfield*, Dagger , Margarita P. Hurtado§, Ronald A. Berkparallel , Joy P. Nanda*, and Lori A. Friedenberg*

From the Schools of * Hygiene and Public Health, Dagger  Medicine, and parallel  Nursing, Johns Hopkins University, Baltimore, Maryland; and the § Institute of Medicine-National Academy of Sciences, Washington, DC.

Objective.  To assess the adequacy of the Primary Care Assessment Tool-Child Edition (PCAT-CE) for evaluating the attainment of the key characteristics of primary care services for children and youth.

Design.  Community-based telephone survey.

Setting.  Specific political subdivision in Washington, DC.

Participants.  Four hundred fifty parents/guardians of offspring 18 years of age or less.

Measures.  Reliability, validity and principal component analysis of 5 scales representing key aspects of the 4 cardinal domains of primary care included in the PCAT-CE. In addition, 2 subdomains (first contact use and extent of affiliation with a primary care source) were included as indices to describe overall patterns of use and affiliation with the particular source of care.

Results.  Most scales had adequate internal consistency, test-retest reliability, and construct validity. The principal components factor analysis yielded 5 separate factors. These corresponded to the subdomains of first contact accessibility; coordination of care; characteristics of the professional-patient relationship over-time; and comprehensiveness (both services available and indicated services received).

Conclusions.  Psychometric assessment supported the integrity and general adequacy of the PCAT-CE for assessing the characteristics and quality of primary care for children and youth. Testing of revised versions in a variety of different settings is underway. A major component of this testing is to explore the possibility of reducing the number of items while retaining sufficient detail about each component of primary care to make judgements about people's experiences with that care.  Key words:  primary care, survey, reliability, validity, scale development.




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