Jeon Ki-Yeob
Owner Physician, Jeonil Medicine Clinic, Department of Internal Medicine, Jeonju, Republic of Korea.
Qual Prim Care. 2011;19(2):85-103.
It is well known that countries with well-structured primary care have better health outcomes, better health equity and reduced healthcare costs. This study aimed to culturally modify and validate the US consumer form of the short Primary Care Assessment Tool (PCAT) in primary care in the Republic of Korea (hereafter referred to as Korea).
The Korean consumer form of the short PCAT (KC PCAT) was cross-culturally modified from the original version using a standardised transcultural adaptation method. A pre-test version of the KC PCAT was formulated by replacement of four items and modification of a further four items from the 37 items of the original consumer form of the short PCAT at face value evaluation meetings. Pilot testing was done with a convenience sample of 15 responders at two different sites. Test-retest showed high reliability. To validate the KC PCAT, 606 clients participated in a survey carried out in Korea between February and May 2006. Internal consistency reliability, test-retest reliability and factor analysis were conducted in order to test validity.
Psychometric testing was carried out on 37 items of the KC PCAT to make the KS PCAT which has 30 items and has seven principal domains: first contact utilisation, first contact accessibility, ongoing accountable care (ongoing care and coordinated rapport care), integrated care (patient-centred care with integration between primary and specialty care or between different specialties), comprehensive care, community-oriented care and culturally-oriented care. Component factors of the verified KS PCAT explained 58.28% of the total variance in the total item scores of primary care.
The verified KS PCAT has been characterised by the seven classic domains of primary care with minor modifications. This may provide clues concerning differences in expectations for primary care in the Korean population as compared with that of the US. The KS PCAT is a reliable and valid tool for the evaluation of the quality of primary care in Korea. It will be used to identify any aspects of primary care linked to better or worse health outcomes, and to provide evidence-based evaluations of or recommendations for Korean healthcare policy.
cross-cultural adaptation, Korean Standard Primary Care Assessment Tool, Primary Care Assessment Tool, quality of primary care.
众所周知，拥有结构完善的初级保健体系的国家，其健康状况更好，健康公平性更佳，医疗成本更低。本研究旨在对美国初级保健评估工具简表（PCAT）的消费者版进行文化调适，并在大韩民国（以下简称韩国）的初级保健环境中进行验证。
采用标准化的跨文化调适方法，对简短PCAT的韩国消费者版（KC PCAT）进行跨文化调适。在表面效度评估会议上，通过替换4个条目和修改另外4个条目，从简短PCAT原始消费者版的37个条目中制定了KC PCAT预测试版。在两个不同地点对15名应答者的便利样本进行了预测试。重测显示出高信度。为验证KC PCAT，2006年2月至5月期间，606名客户参与了在韩国开展的一项调查。进行了内部一致性信度、重测信度和因子分析以检验效度。
对KC PCAT的37个条目进行了心理测量测试，形成了包含30个条目的韩国标准初级保健评估工具（KS PCAT），其有七个主要领域：首诊利用、首诊可及性、持续责任性医疗（持续医疗和协调融洽医疗）、整合医疗（以患者为中心的医疗，整合了初级保健与专科保健或不同专科之间的医疗）、全面医疗、社区导向医疗和文化导向医疗。经验证的KS PCAT的成分因子解释了初级保健总条目得分中总方差的58.28%。
经验证的KS PCAT具有初级保健的七个经典领域的特征，仅有细微修改。这可能为了解韩国人群与美国人群在初级保健期望方面的差异提供线索。KS PCAT是评估韩国初级保健质量的可靠且有效的工具。它将用于识别与更好或更差健康结局相关的初级保健的任何方面，并为韩国医疗政策提供基于证据的评估或建议。
跨文化调适；韩国标准初级保健评估工具；初级保健评估工具；初级保健质量
