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Table 2 Scales for the measurement of performance

From: An evaluation of gender equity in different models of primary care practices in Ontario

Quality of Health Care Service Deliverya (items in the scale, categories in the likert scale of each item) Source of data Overall score rangesc
   Access First contact accessibility (4, 4) Patient survey 74% - 83%
  First contact utilization (3, 4) Patient survey 96% - 98%
   Patient-Provider Humanism (8, 7) Patient survey 90% - 91%
   Relationship Trust (10, 5) Patient survey 87% - 88%
  Cultural competency (3, 4) Patient survey 83% - 85%
  Family centeredness (3, 4) Patient survey 89% - 90%
   Continuity Ongoing care (4, 4) Patient survey 85% - 90%
Technical Quality of Clinical Care Delivery b- Adherence to recommended guidelines (items in the scale)   
   Health Promotion Healthy lifestyle counseling (7) Patient survey 46% - 59%
   Prevention Preventive care (6) Chart audit 52% - 68%
   Chronic Disease Management Chronic disease management (9) Chart audit 60% - 72%
  1. a All health care service delivery scales are based on the PCAT[16, 17], except for the Humanism, [42] and Trust[43] scales.
  2. A respondent's scale was included only if at least 50% of its items contained a response. Performance scores for each health service delivery scale were derived by summing the individual item scores and normalizing these to a percentage. For example, for first contact accessibility, the sum of the scores for the four questions, each on a likert scale of 1-4, is divided by 16
  3. bHealth promotion and prevention evaluations were based on the Canadian Task Force on Preventive Health Care (CTFPHC) clinical practice guidelines[44]. Chronic disease management was assessed against recommended guidelines accepted in Ontario for the management of the conditions [4551].
  4. For health promotion, patients were asked to indicate which of 7 subjects were discussed with them on that day's visit. We assessed whether at least one subject was discussed on that visit, and estimated the overall extent of health promotion delivered yearly by multiplying the number of subjects discussed at the index visit by the patient's estimated number of visits to that practice for the year. Preventive care was determined by assessing the performance of 6 indicator manoeuvres in the chart audit. The prevention score was the proportion of preventive manoeuvres for which the individual was eligible that were documented. Finally, chronic disease management was also evaluated by chart audit using 2-4 indicators in each of three conditions (Diabetes, Coronary Artery Disease and Congestive Heart Failure). For each condition the score was derived as for prevention, and the overall chronic disease management score was the average of the individual disease scores.
  5. cIndicates the range of scores for each scale in the four models.