D'Avila, Otávio Pereira

Harzheim, Erno

Hauser, Lisiane

Pinto, Luiz Felipe da Silva

Journal of General and Family Medicine

English

Lume 5.8

J Gen Fam Med. 2020;21:203–204.    |  203wileyonlinelibrary.com/journal/jgf2 Received: 4 March 2020  |  Accepted: 16 March 2020DOI: 10.1002/jgf2.319  L E T T E R  T O  T H E  E D I T O RQuality indicators for primary care and patients’ experience: A leap beyondTo the Editor,Ozaki et al (2019)1 had evaluated the quality of primary care through-out small facilities using quality indicators (QIs) collected in elec-tronic medical records (EMR) system. They selected 18 QIs based on a comprehensive framework after a modified Delphi method validated by an expert panel members. Besides, the authors also col-lected data on a patient survey in four dimensions presented in the Appendix: access, communication, coordination, and understanding of patient's background. But, unfortunately, these dimensions are not comparable to other studies in primary health facilities. What do we mean by that? We ask why not use a statistically validated international instrument to assess patients' experience in primary care clinics?To measure quality of Japan's medical care, one should argue what patients’ experience is. They play an important role in the assessment of health services, especially in primary care, where clinics and facili-ties are usually near each person/family. Starfield and Shi mentioned by the authors on references #1 and #4 had developed and validated a set of questionnaires to evaluate primary healthcare facilities—the Primary Care Assessment Tool (PCAT),2 and recently, Aoki et al3 also validated a Japanese adult version, the so-called J-PCAT. It has most of the dimensions considered by the authors, which together allow the measurement of an overall IQ (the overall PCAT score), in addition to allowing the specific calculation for each of the attributes: access—first contact, ongoing care, comprehensiveness (services available), comprehensiveness (services provided), and community orientation.The use of PCAT is widespread in health services in Brazil, in the states of São Paulo, Rio de Janeiro and especially in Rio Grande do Sul. In agreement with Ozaki et al (2019),1 when they mention that primary care plays an “increasingly important role in the healthcare sys-tem,” we propose a leap beyond. Why not outline a national policy for primary care assessment including users’ perspective? Thinking about this issue, in early 2019, the Brazilian Ministry of Health sought Brazilian Institute of Geography and Statistics (IBGE)—the Statistics Bureau of Brazil—to include in its main National Health Survey (PNS-2019), the set of questions that forms Brazilian Adult PCAT reduced version.4,5Therefore, we encourage the authors in future studies to focus on expanding their research in community clinics in Japan using J-PCAT for the assessment of patients’ experience, helping to foster a baseline to compare nationwide primary care facilities. It could be used not only for health service research, but for a Japanese primary care policy, as Brazilian Federal Government is innovating since 2019, consider-ing it for Family Health Teams (that form the basis of the health sys-tem in Brazilian primary care), to evaluate the quality of primary care throughout a part of a pay-for-performance program implemented.ACKNOWLEDG EMENTSThe authors would like to thank the Brazilian Ministry of Health and Brazilian Institute of Geography and Statistics (IBGE)—the Statistics Federal Bureau of Brazil—to include in the National Health Survey (PNS-2019), PCAT questions.CONFLIC T OF INTERE S TThe authors declare no conflict of interests for this article.Luiz Felipe Pinto PhD1,2Erno Harzheim MD, PhD3Otávio Pereira D’Avila PhD4Lisiane Hauser PhD51Department of Primary Health Care in Medicine, School of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil2Instituto de Higiente e Medicina Tropical (IHMT), Universidade Nova de Lisboa, Nova de Lisboa, PortugalEmail: felipepinto.rio@medicina.ufrj.br3School of Medicine, Federal University of Rio Grande do Sul (UFRGS), Rio de Janeiro, Brazil4School of Dentist, Federal University of Pelotas, Rio Grande do Sul (UFPel), Rio de Janeiro, Brazil5Brazilian Health Ministry, Rio de Janeiro, BrazilORCIDLuiz Felipe Pinto  https://orcid.org/0000-0002-9888-606X R E FE R E N C E S 1. Ozaki M, Matsumura S, Iwamoto M, Kamitani S, Higashi T, Toyama M et al Quality of primary care provided in community clinics in Japan. J Gen Fam Med. 2019;20:48–54.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.© 2020 The Authors. Journal of General and Family Medicine published by John Wiley & Sons Australia, Ltd on behalf of Japan Primary Care Association204  |     LETTER TO THE EDITOR 2. Johns Hopkins Bloomberg School of Public Health. The Johns Hopkins Primary Care Policy Center. Primary Care Assessment Tools. Baltimore; 2016. [Internet] [cited March 2020]. Available from http://www.jhsph.edu/resea rch/cente rs-and-insti tutes /johns -hopki ns-prima ry-care-polic y-cente r/pca_tools.html 3. Aoki T, Inouec M, Nakayamad T. Development and validation of the Japanese version of Primary Care Assessment Tool. Fam Pract. 2016;33:112–7. 4. Brazil. Brazilian Institute of Geography and Statistics (IBGE). National Health Survey. For the first time, IBGE carries out survey on patient check-in in public health system. [Internet] [cited March 2020]. Available from https://agenc iaden otici as.ibge.gov.br/en/agenc ia-news/2184-news-agenc y/news/25542 -for-the-first -time-ibge-carri es-out-surve y-on-patie nt-check -in-in-publi c-healt h-system 5. Brazil. Federal University of Rio Grande do Sul (UFRGS). Launch of Fieldwork of Brazilian National Health Survey (PNS-2019) from Brazilian Institute of Geography and Statistics (IBGE) – Telessaúde, RS - UFRGS. Questionnaire – Primary Health Care – PCAT. [Internet] [cited March 2020]. Available from https://www.ufrgs.br/teles saude rs//docum entos /PNS20 19_MODULO_H_versao_ingles.pdf.pdf

Quality indicators for primary care and patients’ experience : a leap beyond

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Quality indicators for primary care and patients’ experience : a leap beyond

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