Examination of Primary Care Characteristics in a Community-based Clinic


  • Lou Ann Hartley

    Corresponding author
    1. Lou Ann Hartley, MSN, CNAA-BC, PAHM, Nu Alpha, Doctoral Student, University of Kentucky, College of Nursing, Lexington, KY, and Associate Professor, Marshall University, College of Nursing and Health Professions, Huntington, WV
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  • The author thanks the patients who participated in this study, Shane Hammock, MSN, for serving as a research assistant and Dr. Lynne A. Hall, RN, DrPH, University of Kentucky College of Nursing for suggestions concerning this manuscript. Delta Psi Chapter of Sigma Theta Tau International provided funding for this study.

Ms. Hartley, 803 Shrewsbury Drive, St. Albans, WV 25177. E-mail: hartley@marshall.edu


Purpose: To (a) examine the reliability and validity of the Primary Care Assessment Survey (PCAS), (b) describe the primary care characteristics of a community-based clinic in an underserved area in Appalachia, (c) examine the relationships between primary care characteristics and socioeconomic factors, (d) compare and contrast patients who have regular providers of care with those who did not have regular providers of care; and (e) examine provider primary care characteristics that predict comprehensive knowledge of patients.

Design: Data for this cross-sectional survey (N=227) were collected over a 4-month period using face-to-face interviews at a not-for-profit, community-based clinic serving patients in three Appalachian states in the southeastern United States.

Methods: The PCAS was used to measure 11 domains of primary care provider performance and to identify and group patients who had regular providers of care (n=126) and patients who did not have regular providers of care (n=98) at the clinic.

Findings: Cronbach's coefficient alpha for the total scale was .74 after deleting one subscale. Factor analysis revealed one PCAS dimension, Communication, accounting for 44% of the total variance. Primary care providers' Interpersonal Treatment and Longitudinal Continuity were predictors of Comprehensive Knowledge of the patient and accounted for 26% and 6% of the variance, respectively.

Conclusions: The PCAS showed evidence of reliability and validity with underserved Appalachian patients receiving care in a community-based clinic. The findings showed that patients receiving care from primary care providers had sustained relationships that affected communication aimed at improving primary care outcomes.