Primary Care Assessment Survey (PCAS) Print E-mail

Original Citation – Safran DG, Kosinski M, Tarlov AR, Rogers WH, Taira DH, Lieberman N, Ware JE. The Primary Care Assessment Survey: tests of data quality and measurement performance. Med Care. 1998 May;36(5):728-39. View in PubMed

Contact Information
Angela Li
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Price & Availability – Freely available on instrument website. To gain access to the questionnaire and its supporting documentation, please visit instrument website and complete the required forms. Full instrument and short-form available.

Brief Description of Instrument – Operationalization of formal definitions of primary care. The survey measures 7 defining characteristics of primary care through 11 summary scales, including detailed measurement of the doctor-patient relationship (communication quality, patient trust, physician knowledge of patient, interpersonal treatment, relationship duration).

Scale Format – Primarily 5 or 6-point Likert. Also includes yes/no, multiple-choice, visual analogue. 51-item.

Administration Technique – Self-administered questionnaire.

Scoring and Interpretation – Please see scoring guide for details. Scoring program written in SAS. All scales range from 0-100 points with higher scores indicating more of the underlying attribute.

Factors and Norms – 11 summary scales: 1) Financial access, 2) organizational access, 3) longitudinal continuity, 4) visit-based continuity, 5) contextual knowledge of the patient, 6) preventative counselling, 7) integration of care, 8) communication, 9) physical examinations, 10) interpersonal treatment, 11) trust.

Internal Consistency – Summary scales range from 0.74 to 0.95. Please see original citation for details.

Construct Validity – Instrument satisfies assumptions for summated rating scales including: item-convergent validity, item-discriminant validity, equal item variance, equal item-scale correlations and score reliability. Summary scales found to be unique through testing of inter-scale correlations.

Content & Face Validity – Scale development based on Institute of Medicine (IOM) formal definition of primary care. All concepts in scale are measured in the context of a specific provider-patient relationship, not visit specific, to be consistent with IOM definition.

Strengths – Extensive psychometric testing completed, found to be both reliable and valid. Performs consistently well across population subgroups (age, sex, education, race, household income and health status).

Published APN Studies using instrument – Lenz ER, Mundinger MO, Kane RL, Hopkins SC, Lin SX. Primary care outcomes in patients treated by nurse practitioners or physicians: two-year follow-up. Med Care Res Rev. 2004 Sep;61(3):332-51. View in PubMed

Related Methods Articles (Not Reviewed) – Campbell SM, Hann M, Roland M0, Hacker J, Burns C, Oliver D, Thapar A, Mead N, Safran DG. Do single-handed practices provide poorer quality of care than larger practices? A multi-dimensional assessment of quality of care. British Medical Journal October 2001; 323 (7316):784-789.
Rodriguez HP, von Glahn T, Rogers WH, Chang H, Fanjiang G, Safran DG. Evaluating patients’ experiences with individual physicians: a randomized trial of mail, internet and interactive voice response (IVR) telephone administration of surveys. Medical Care. 2006; 44(2): 167-174.
Safran DG, Karp M, Coltin K, Ogren J, Li A, Chang H, Rogers WH. Measuring patients’ experiences with individual physicians. Journal of General Internal Medicine. 2006; 21(1): 13-21.

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