Definitions of Accessibility and Continuity of Primary Health Care
| Conceptual Definition | Operational Definition of Minimal Expectation (PCAT Subscale) |
|---|---|
| PCAT=Primary Care Assessment Tool. | |
| a In Canada, all physicians who are not general practitioners or family physicians are specialists. | |
| First-contact accessibility: the ability of a person to obtain needed care (including advice and support) from the practitioner of choice within a time frame appropriate to the urgency of the problem20 | Patients should express confidence that they could probably get advice or be seen within 1 day by someone at their regular clinic if they suddenly get sick and need care. (First-Contact Access PCAT subscale, 4 items) |
| Relational continuity: a therapeutic relationship with a practitioner that spans more than 1 episode of care and leads, in the practitioner, to a sense of clinical responsibility and an accumulated knowledge of the patient’s personal and medical circumstances5 | Accumulated knowledge: patients should express confidence that their physician probably knows their medical history and personal situation. (Ongoing Care PCAT subscale, 8 items) Clinical responsibility: patients should express confidence that their physician’s clinical responsibility probably extends beyond the clinical encounter. (Ongoing Care PCAT subscale, 4 items) |
| Coordination continuity: the delivery of services by different practitioners in a timely and complementary manner so that care is connected and cohesive for the patient5 | Patients should express confidence that their primary care physician and the specialistsa communicate and collaborate in their care. (Coordination PCAT subscale, 8 items) |