Development and validation of a concise scale for assessing patient experience of primary care for adults in Japan

Background: The existing scales to measure patient experience of primary care for adults tend to be with many items and difficult to use outside of the research setting. Objective: To develop a Japanese version of Primary Care Assessment Tool Short Form as a concise scale for assessing patient experience of primary care and to examine its validity and reliability. Methods: We conducted a cross-sectional survey in a primary care practice-based research network in Japan (25 primary care facilities). We evaluated the structural validity, criterion-related validity, convergent validity and the internal consistency reliability of the scale. Results: Data were analysed for 1725 primary care outpatients. A 13-item scale was constructed, and the confirmatory factor analysis showed excellent goodness of fit of the six-factor model (first contact, longitudinality, coordination, comprehensiveness (services available), comprehensiveness (services provided) and community orientation). Pearson correlation coefficients between the total score and the overall rating of care and the original scale total score were 0.43 and 0.94, respectively. The total score was positively associated with influenza and pneumococcal vaccination (P < 0.001; P = 0.009 for trend). All of the multi-item scales achieved good internal consistency and the overall Cronbach's alpha was 0.77. Conclusions: We developed a concise patient experience scale, which comprises six domains measuring primary care attributes and evaluated its validity and reliability. This scale can be used as a rapid assessment tool reducing the burden of respondents and provide effective information for further quality improvement and practice-based research in the Japanese primary care settings.