Table 1.

Definitions of Accessibility and Continuity of Primary Health Care

Conceptual DefinitionOperational 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 problem20Patients 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 circumstances5Accumulated 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 patient5Patients should express confidence that their primary care physician and the specialistsa communicate and collaborate in their care. (Coordination PCAT subscale, 8 items)