Development and Validation of the Japanese Version of Primary Care Assessment Tool

Background: Tools for assessing quality of primary care from patient experience have never previously existed in Japan.

Objective: The aim of this study was to develop the Japanese version of Primary Care Assessment Tool (JPCAT) and to examine the validity of this tool in the assessment of the quality of primary care from patient experience in Japan.

Methods: We used a cross-sectional mail survey to test the validity and reliability of JPCAT. The questionnaire was sent to 1100 residents, 40-75 years of age, who were randomly selected from a basic resident register in Kita City, Tokyo, Japan. We examined internal consistency included Cronbach's alpha, exploratory factor analysis, multi-trait analysis and correlation between overall user satisfaction scores and JPCAT total scores.

Results: The tool was developed using responses from 204 residents, out of a total of 402 participants in the survey (50.7%), who had the usual sources of care. A 29-item JPCAT was constructed to include six multi-item subscales, representing each of the five primary care principles (first contact, longitudinality, comprehensiveness, coordination and community orientation). All of the multi-item scales achieved good internal consistency, item-total correlations and construct validity. The overall Cronbach's alpha coefficient was 0.90. The Spearman correlation coefficient between the JPCAT total score and the overall user satisfaction was 0.58. Scaling assumptions tests were well satisfied. The full range of possible scores was observed for all scales except the longitudinality domain.

Conclusions: We developed JPCAT and examined its validity and reliability in assessing the core principles of primary care in Japan. This tool could be used for health service research in primary care.