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Parental assessment is a practical and reliable way to measure pediatric primary care

It turns out that parents are pretty good judges of pediatric primary care. Several measures of the quality of pediatric primary care exist. However, they require an interviewer, are lengthy, or are impractical in other ways. A new study demonstrates the success of a brief and valid measure of pediatric primary care from the parent's unique perspective.

The Parent's Perceptions of Primary Care measure (P3C) is a 23-item questionnaire that asks parents to evaluate the elements of primary care as defined by the Institute of Medicine. Essentially, the P3C elicits from the parent an evaluation of certain characteristics of his or her child's primary care which, when present, constitute high quality care.

With support from the Agency for Healthcare Research and Quality (HS10317), Michael Seid, Ph.D., and colleagues at the Children's Hospital and Health Center, San Diego, administered the P3C to 3,371 parents of elementary school children in a large, diverse urban area. The P3C questionnaire yields a total score, as well as subscale scores for care continuity, access to care (timeliness and convenience), contextual knowledge (doctor's awareness of the parent's values and medical care preferences, clear understanding of the child's health needs, and familiarity with the child's medical history), adequacy of doctor's communication, comprehensiveness of care, and coordination of care (doctor's knowledge of other medical visits and followup of problems via later visits or phone calls).

The researchers found the P3C to have good internal consistency, reliability, and validity. The quality of pediatric primary care was higher (higher P3C scores) when children had health insurance, their parents completed the survey in English (the P3C was also translated into Spanish, Vietnamese, and Tagalog), and they had a regular doctor. P3C scores were positively related to parental reports of the child's health-related quality of life. The P3C can be used by pediatricians and medical groups that are interested in improving their care and by policymakers who can use it to measure the experiences of children covered by Medicaid and minority children who may have limited English ability.

More details are in "Parents' perceptions of primary care (P3C): Measuring parents' experiences of pediatric primary care quality," by Dr. Seid, James W. Varni, Ph.D., Laura Olson Bermudez, Ph.D., and others, in the August 2001 Pediatrics 108(2), pp. 264-270.

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