<p>Internal consistency.</p>

Introduction
The Primary Care Assessment Tool (PCAT) is designed to assess a patient’s experience with primary care across various core and ancillary domains, including First contact – Utilization, First contact – Access, Ongoing Care, Coordination, Comprehensiveness (services provided), Family-centeredness, Community Orientation, and Cultural Competence. This study examined the psychometric properties of the Adult Primary Care Assessment Tool Short Form (PCAT-S) in the Australian general practice setting.
Method
Data included 715 participants from the EQuIP-GP study, a cluster randomized controlled trial (RCT) conducted with adults aged 18–65 years with a chronic illness or aged over 65 years, from 34 general practices across Australia. For each subscale we assessed internal consistency using Cronbach’s alpha. Factor structure of the PCAT-S instrument was assessed through confirmatory and exploratory factor analysis, using three samples with different methods for handling ‘don’t know/can’t remember’ responses.
Results
The findings were mixed. Specifically, the subscales related to First Contact – Utilization, Ongoing Care and Comprehensiveness, demonstrated satisfactory internal consistency. However, the remaining subscales showed weak internal consistency. Confirmatory factor analysis indicated potential model misspecification, while exploratory factor analysis generally supported the hypothesized factor structure, albeit with some observed deviations.
Conclusions
The findings indicate the PCAT-S shows promise as an instrument to evaluate primary care experiences in Australia. However, the observed variability in internal consistency, along with issues identified in confirmatory and exploratory factor analyses, highlight the need for further validation and refinement in this population. Further research is required to address the identified limitations and enhance the tool’s applicability within the Australian general practice context.

引言
初级保健评估工具（Primary Care Assessment Tool，PCAT）旨在从多个核心与辅助维度评估患者的初级保健体验，涵盖首诊接触-利用情况、首诊接触-可及性、持续照护、协调照护、服务全面性（所提供的服务）、以家庭为中心、社区导向以及文化胜任力。本研究针对澳大利亚全科诊疗场景下的成人版初级保健评估工具简表（Adult Primary Care Assessment Tool Short Form，PCAT-S）的心理测量学特性展开了考察。

方法
本研究的数据来自EQuIP-GP研究的715名受试者。该研究为一项整群随机对照试验（cluster randomized controlled trial，RCT），纳入了澳大利亚34家全科诊所的18~65岁慢性病成年患者及65岁以上老年人群。针对每个分量表，本研究采用克朗巴哈α系数评估其内部一致性。通过验证性因子分析与探索性因子分析，结合三种针对“不知道/记不清”作答的不同处理方法，对PCAT-S的因子结构进行了考察。

结果
研究结果存在分歧。具体而言，与首诊接触-利用情况、持续照护及服务全面性相关的分量表表现出良好的内部一致性；但其余分量表的内部一致性较弱。验证性因子分析结果提示存在潜在的模型设定偏误，而探索性因子分析总体上支持假设的因子结构，尽管存在部分观测到的偏差。

结论
研究结果表明，PCAT-S具备作为澳大利亚初级保健体验评估工具的应用潜力。然而，观测到的内部一致性差异，以及验证性与探索性因子分析中发现的问题，凸显了针对该人群开展进一步验证与优化的必要性。后续研究需针对已识别的局限性进行改进，以提升该工具在澳大利亚全科诊疗场景中的适用性。