Canadian Family Physician
Volume 62, Issue 1, 2016, Pages e23-e30

Academic family health teams part 1: patient perceptions of core primary care domains (Article)

Carroll J.C.* , Talbot Y. , Permaul J. , Tobin A. , Moineddin R. , Blaine S. , Bloom J. , Butt D. , Kay K. , Telner D.
  • a Mount Sinai Academic Family Health Team, Department of Family and Community Medicine, University of TorontoON, Canada
  • b Mount Sinai Academic Family Health Team, Department of Family and Community Medicine, University of TorontoON, Canada
  • c Ray D. Wolfe Department of Family Medicine, Mount Sinai Hospital, Canada
  • d University of Toronto, Wilson Centre, University Health Network, Canada
  • e Department of Family and Community Medicine, University of Toronto, Institute for Clinical Evaluative Sciences, Dalla Lana School of Public Health, University of Toronto, Canada
  • f STAR Family Health Team, Department of Family and Community Medicine, University of Toronto, Canada
  • g University Health Network, Department of Family and Community Medicine, University of Toronto, Canada
  • h Scarborough Hospital, Department of Family and Community Medicine, University of Toronto, Canada
  • i Geriatric Assessment and Intervention Network, Lakeridge Health, Oshawa, ON, Canada
  • j South East Toronto Family Health Team, Department of Family and Community Medicine, University of Toronto, Canada

Abstract

Objective To explore patients perceptions of primary care (PC) in the early development of academic family health teams (aFHTs)-interprofessional PC teams delivering care where family medicine and other health professional learners are trained-focusing on the 4 core domains of PC. Design Self-administered survey using the Primary Care Assessment Tool Adult Expanded Version (PCAT), which addresses 4 core domains of PC (first contact, continuity, comprehensiveness, and coordination). The PCAT uses a 4-point Likert scale (from definitely not to definitely) to capture patients responses about the occurrence of components of care. Setting Six aFHTs in Ontario. Participants Adult patients attending appointments and administrators at each of the aFHTs. Main outcome measures Mean PCAT domain scores, with a score of 3 chosen as the minimum expected level of care. Multivariate log binomial regression models were used to estimate the adjusted relative risks of PCAT score levels as functions of patient- and clinic-level characteristics. Results The response rate was 47.3% (1026 of 2167). The mean age of respondents was 49.6 years, and most respondents were female (71.6%). The overall PC score (2.92) was just below the minimum expected care level. Scores for first contact (2.28 [accessibility]), coordination of information systems (2.67), and comprehensiveness of care (2.83 [service available] and 2.36 [service provided]) were below the minimum. Findings suggest some patient groups might not be optimally served by aFHTs, particularly recent immigrants. Characteristics of aFHTs, including a large number of physicians, were not associated with high performance on PC domains. Distributed practices across multiple sites were negatively associated with high performance for some domains. The presence of electronic medical records was not associated with improved performance on coordination of information systems. Conclusion Patients of these aFHTs rated several core domains of PC highly, but results indicate room for improvement in several domains, particularly first-contact accessibility. A future study will determine what changes were implemented in these aFHTs and if patient ratings have improved. This reflective process is essential to ensuring that aFHTs provide effective models of PC to learners of all disciplines.

Author Keywords

[No Keywords available]

Index Keywords

general practice education coordination perception immigrant primary medical care university hospital human middle aged Aged human versus animal comparison family health administrative personnel clinical study Surveys and Questionnaires Young Adult Humans Adolescent model male Canada female Aged, 80 and over very elderly risk factor Health Information Systems electronic medical record Multivariate Analysis medical information system questionnaire Electronic Health Records patient satisfaction electronic health record standards Ontario adult health care quality Academic Medical Centers information system Quality of Health Care statistical model hospital attitude to health Health Services Accessibility primary health care Family Practice health care delivery
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84955571724&partnerID=40&md5=0f1529a4e8803655c932d9dbad065f35
ISSN: 0008350X
Cited by: 4
Original Language: English