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PEDIATRICS Vol. 108 No. 2 August 2001, pp. 264-270

Parents' Perceptions of Primary Care: Measuring Parents' Experiences of Pediatric Primary Care Quality

Received Sep 28, 2000; accepted Dec 15, 2000.

Michael Seid*, James W. Varni*, Dagger , Laura Olson Bermudez*, Mirjana Zivkovic*, Maryam Davodi Far*, Melissa Nelson*, and Paul S. Kurtin*

From the * Center for Child Health Outcomes, Children's Hospital and Health Center, San Diego, California; and Dagger  Department of Psychiatry, University of California San Diego School of Medicine, San Diego, California.

Objective.  A measure of pediatric primary care quality that is brief, practical, reliable, and valid would be useful to patients and pediatricians, policymakers, and health system leaders. Parents have a unique perspective from which to report their experiences with their child's primary care, and these reports may be valid indicators of pediatric primary care quality. The research objective was to develop a brief parent report of their children's primary care, the Parent's Perceptions of Primary Care measure (P3C), and to test its reliability and validity as a measure of pediatric primary care quality.

Study Design.  The P3C was based on the elements of primary care as defined by the Institute of Medicine. Pretesting of domain content and item clarity was accomplished via focus interviews. The P3C was developed in English and translated to Spanish, Vietnamese, and Tagalog. The 23-item P3C yields a total score, as well as subscale scores for continuity, access, contextual knowledge, communication, comprehensiveness, and coordination. The P3C was administered to 3371 parents of children in kindergarten through sixth grades in a large, urban school district.

Principal Findings.  The percentage of missing values for the overall sample was 1.88%, indicating acceptable feasibility. Range of measurement, assessed via floor and ceiling effects, was moderate to good. Cronbach's coefficient alpha , an indicator of scale internal consistency reliability, was 0.95 for the P3C total scale. Factor analysis supported the subscale structure, and P3C scores were higher for children with health insurance, whose parents completed the survey in English, and who had a regular physician. P3C scores were positively related to parent reports of the child's health-related quality of life.

Conclusions.  The P3C is a practical, reliable, and valid measure of parents' reports of pediatric primary care quality. This brief measure could be used alone, or in conjunction with other measures, to enhance outcomes and evaluate the impact of systems changes on the delivery of the main elements of primary care.  Key words:  quality of healthcare, outcome and process assessment (healthcare), primary healthcare, measurement, questionnaires.




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