Trends in the evolution of health services organization and delivery have prompted new research and programmatic efforts in the area of primary care. Among such initiatives is the federal Maternal and Child Health Bureau's core support provided to develop, test, and disseminate models of instruments to describe and assess the scope and nature of primary care provided to children and adolescents.
This work, which has been ongoing for several years, began with Center assistance to the federal MCH agency in developing a definition of primary care specific to children and adolescents. The definition is operationalized by several unique attributes. These include first-contact care, continuity, comprehensiveness, and coordination. In addition, primary care shares certain characteristics with other types of health care such as community-orientation, family-centeredness, and cultural competence.
Stemming from this theoretical framework, Primary Care Assessment Tools (PCAT) have been developed to collect and analyze information needed to describe the characteristics of primary care provided to children. Rather than identifying health outcomes, these assessments are designed to describe the organizational resources and processes that influence those outcomes.
Several derivative resources resulted from this project, including:
- Child Health Systems Primary Care Assessment: Community Self-Assessment Guide. (1995). Alyssa Wigton and Holly Grason.
- Child Health Needs Assessment: A Review of Data Sources to Measure Child Health Status. A Technical Resource Brief. (1995). Donna Strobino.
- MCH Policy Research Brief: Improving Access to Primary Care for Adolescents: School Health Centers as a Service Delivery Strategy. (1995). John Santelli, Madlyn Morreale, Alyssa Wigton, and Holly Grason.
The development of the pediatric primary care assessment framework and tools represents a partnership that, over time, has involved the financial and administrative commitment of the federal MCH agency and several state and local MCH programs and academic research centers. In addition, the Henry J. Kaiser Family Foundation provided support for a project designed to assess whether information for monitoring the quality of primary care can be validly obtained from provider and population surveys and to determine the extent to which primary care is achieved for populations enrolled in different types of health care organizations and plans.
WCHPC faculty and staff published two articles that document use of the primary care assessment tools:
- Starfield B, Cassady C, Nanda J, Forrest CB, Berk R, 1998. Consumer experiences and provider perceptions of the quality of primary care: Implications for managed care. J Fam Pract. Mar;46(3):216-26.
- Cassady CE, Starfield B, Hurtado MP, Berk RA, Nanda JP, Friedenberg LA, 2000. Measuring consumer experiences with primary care. Pediatrics. Apr;105(4 Pt 2):998-1003.
Faculty taking the lead on these projects are Barbara Starfield and Christopher Forrest from the Department of Health Policy and Management.