MEASURING ATTRIBUTES OF PRIMARY-CARE - DEVELOPMENT OF A NEW INSTRUMENT

BACKGROUND. The purpose of this study was to evaluate the measurement properties of an instrument developed to measure seven key aspects of the delivery of primary care from the perspective of patients visiting their family physician, and to report the association of these aspect s with patient satisfaction. METHODS. A cross-sectional study design w as used to examine the responses of 2899 patients visiting 138 family physicians' offices in Northeast Ohio. A 20-item research tool, the Co mponents of Primary Care index (CPCI), was created to measure the doma ins of primary care based on the new Institute of Medicine definition and on additional domains based on the literature. Patient satisfactio n was measured with the Medical Outcomes Study 9-item visit rating for m. The usual provider continuity (UPC) index was calculated as the pro portion of visits to the index physician with relation to all physicia n visits for the past year by patient report. The CPCI was subjected t o item and factor analysis, Scale scores were computed, and the associ ation with patient satisfaction with the visit was tested by correlati on. RESULTS. The factor analysis resulted in four stable and internall y consistent factors. The factors were named: interpersonal communicat ion, physician's accumulated knowledge of the patient, coordination of care, and patients' preference to see their regular physician, Each o f the CPCI scale scores was significantly associated with patient sati sfaction with the visit. The UPC index, length of time as a patient, a nd intensity of visits were not as strongly associated with the patien t satisfaction measure. CONCLUSIONS. The CPCI provides a brief and rel iable measure of four important aspects of the delivery of primary car e, The components of primary care are associated with patient satisfac tion with visits to family physicians. The CPCI could be used with oth er outcomes and to assess the effect of interventions and systems chan ges on the delivery of critical aspects of primary care.