In 1994, the Institute of Medicine (IOM) proposed a function-orientated definition of primary care, which is consistent with the widely acknowledged multidimensional concept of primary care with its emphasis on the four core dimensions of primary care (i.e., first contact, continuity, comprehensiveness, and coordination) [3–5].
In urban China, primary care is defined as “the delivery of comprehensive, continuous, and convenient episodic and preventive health care services to families in the community” , which are mostly provided by general practitioners (GPs) in community health centers (CHCs) or other health stations or clinics .
There are some favorable changes; for example, general practitioners (GPs) who are at the frontier in providing primary care have gradually acquired a good local reputation and attracted large numbers of patients.
Meanwhile, the social health insurance have covered approximately 95% of the population and its reimbursement strategy has strengthened the use of primary care and the promotion of CHCs as a potential gatekeeper [12–14].
As an economically developed district in southern China, Guangdong province has long recognized the importance of primary care in promoting health for the general public and has launched pilot programs for regional primary care reform since 1996 .
PCAT has been highly recommended over other measurement tools when assessing the process of primary care and is available in various formats [26, 30–32].
Primary Care Assessment Tool-Adult Edition (PCAT-AE) is designed to measure adult patients’ experience of primary care.
The principal component analysis extracted five multiple-item scales (first contact utilization, first contact accessibility, ongoing care, comprehensiveness, and coordination).
The tests of scaling assumptions were basically met. The standard psychometric evaluation indicates that the scales have achieved relatively good reliability and validity.
Eight community health centers in Guangdong province have been selected to participate in the survey. A total of 1465 effective samples were included for data analysis.
Eight items were eliminated following principal component analysis and reliability testing.
Although these studies have been essential, they largely fell short on evidence of the core dimensions of primary care.
A previous systematic review has demonstrated that the four core dimensions determine the primary care process .
Primary care is deemed stronger with better fulfillment of these dimensions .