title: Academic family health teams:   Part 1: patient perceptions of core primary care domains.
abstract: OBJECTIVE
  To explore patients' perceptions of primary care (PC) in the early development of academic family health teams (aFHTs)--interprofessional PC teams delivering care where family medicine and other health professional learners are trained--focusing on the 4 core domains of PC.
  
  
  METHODS
  Self-administered survey using the Primary Care Assessment Tool Adult Expanded Version (PCAT), which addresses 4 core domains of PC (first contact, continuity, comprehensiveness, and coordination). The PCAT uses a 4-point Likert scale (from definitely not to definitely) to capture patients' responses about the occurrence of components of care.
  
  
  METHODS
  Six aFHTs in Ontario.
  
  
  METHODS
  Adult patients attending appointments and administrators at each of the aFHTs.
  
  
  METHODS
  Mean PCAT domain scores, with a score of 3 chosen as the minimum expected level of care. Multivariate log binomial regression models were used to estimate the adjusted relative risks of PCAT score levels as functions of patient- and clinic-level characteristics.
  
  
  RESULTS
  The response rate was 47.3% (1026 of 2167). The mean age of respondents was 49.6 years, and most respondents were female (71.6%). The overall PC score (2.92) was just below the minimum expected care level. Scores for first contact (2.28 [accessibility]), coordination of information systems (2.67), and comprehensiveness of care (2.83 [service available] and 2.36 [service provided]) were below the minimum. Findings suggest some patient groups might not be optimally served by aFHTs, particularly recent immigrants. Characteristics of aFHTs, including a large number of physicians, were not associated with high performance on PC domains. Distributed practices across multiple sites were negatively associated with high performance for some domains. The presence of electronic medical records was not associated with improved performance on coordination of information systems.
  
  
  CONCLUSIONS
  Patients of these aFHTs rated several core domains of PC highly, but results indicate room for improvement in several domains, particularly first-contact accessibility. A future study will determine what changes were implemented in these aFHTs and if patient ratings have improved. This reflective process is essential to ensuring that aFHTs provide effective models of PC to learners of all disciplines.
authors.forename: June C
authors.initials: JC
authors.lastname: Carroll
authors.forename: Yves
authors.initials: Y
authors.lastname: Talbot
authors.forename: Joanne
authors.initials: J
authors.lastname: Permaul
authors.forename: Anastasia
authors.initials: A
authors.lastname: Tobin
authors.forename: Rahim
authors.initials: R
authors.lastname: Moineddin
authors.forename: Sean
authors.initials: S
authors.lastname: Blaine
authors.forename: Jeff
authors.initials: J
authors.lastname: Bloom
authors.forename: Debra
authors.initials: D
authors.lastname: Butt
authors.forename: Kelly
authors.initials: K
authors.lastname: Kay
authors.forename: Deanna
authors.initials: D
authors.lastname: Telner
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D057286:Electronic Health Records; D005194:Family Practice / Q000193:education / Q000592:standards*; D005260:Female; D063005:Health Information Systems; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009864:Ontario; D017060:Patient Satisfaction; D011320:Primary Health Care / Q000592:standards*; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D055815:Young Adult