Catalan Agency for Health Information, Assessment and Quality, Barcelona, Spain.
BMC Public Health. 2011 May 9;11:285. doi: 10.1186/1471-2458-11-285.
The Primary Care Assessment Tool (PCAT) is an interesting set of tools for primary care research. A very short version could inform policy makers about consumer experiences with primary care (PC) through health surveys. This work aimed to investigate the validity and reliability of a selection of items from the child short edition (CS) of the PCAT.
A 24 item questionnaire permitted the identification of a regular source of care and the assessment of the key attributes of first contact, ongoing care over time, coordination, services available and services received (comprehensiveness), and cultural competence. Structural validity, reliability, and construct validity were assessed using responses from 2,200 parents of a representative sample of the population aged 0 to 14 years in Catalonia (Spain) who participated in the 2006 Health Survey. Structural validity was analyzed using exploratory and confirmatory factor analyses and reliability was assessed using Cronbach's alpha. Construct validity was assessed using linear regression analysis between PC experience scores and a measure of overall user satisfaction with healthcare services.
A total of 2,095 (95.2%) parents provided useable responses on PC. After Confirmatory Factor Analysis (CFA), the best fitting model was a 5-factor model in which the original dimensions of first contact and ongoing care were collapsed into one. The CFA also showed a second order factor onto which all domains except services available loaded (root mean square error of approximation = 0.000; comparative fit index = 1.00). Cronbach's alpha values for one of the original scales (first-contact) was poor (alpha < 0.50), but improved using the modified factor structure (alpha > 0.70). Scores on the scales were correlated with satisfaction with healthcare services (p < 0.01), thereby providing some preliminary evidence of construct validity.
This very short questionnaire obtained from the PCAT-CE yields information about five attributes of PC and a summary score. It has shown evidence of validity and reliability for judgments about experiences with primary care overall. If space on surveys is at a premium, the instrument could be useful as a measure of PC experiences.
初级保健评估工具（PCAT）是初级保健研究的一组有趣工具。通过健康调查，一个非常简短的版本可以为决策者提供有关消费者对初级保健（PC）体验的信息。本研究旨在调查 PCAT 儿童简短版（CS）中一组精选项目的有效性和可靠性。
一个包含 24 个项目的问卷可以确定常规医疗服务来源，并评估初级保健的关键属性，包括首次接触、随时间推移的持续护理、协调、可提供的服务和已获得的服务（全面性）以及文化能力。使用来自加泰罗尼亚（西班牙）2006 年健康调查中代表性的 0 至 14 岁人群的 2200 名父母的回答评估结构有效性、可靠性和构念有效性。结构有效性通过探索性和验证性因子分析进行分析，可靠性通过 Cronbach's alpha 进行评估。构念有效性通过 PC 体验评分与整体医疗保健服务用户满意度测量之间的线性回归分析进行评估。
共有 2095 名（95.2%）父母提供了 PC 相关的可用回复。在验证性因子分析（CFA）之后，最佳拟合模型是一个 5 因素模型，其中原始的首次接触和持续护理维度合并为一个。CFA 还显示了第二个二阶因子，所有除了可提供的服务外的其他领域都加载到该因子上（近似均方根误差=0.000；比较拟合指数=1.00）。原始量表之一（首次接触）的 Cronbach's alpha 值较差（alpha<0.50），但使用修改后的因子结构后得到了改善（alpha>0.70）。量表得分与对医疗保健服务的满意度相关（p<0.01），从而提供了一些构念有效性的初步证据。
从 PCAT-CE 中获得的这个非常简短的问卷提供了有关 PC 的五个属性和综合评分的信息。它已经证明了对整体初级保健体验的有效性和可靠性。如果调查空间有限，该工具可以作为评估初级保健体验的一种手段。
