An operational definition of “primary care”, useful to a wide variety of professionals, has eluded researchers since the term first gained popularity. This paper presents an activity-based definition of primary care derived from ratings of 59 representative health care activities by a group of state health administrators, a group of local health department directors, and a random sample of primary care physicians practicing in North Carolina. Thirty-one activities received ratings indicating they were considered core primary care services. Examination of differences in ratings among the three groups surveyed suggests that health department directors differ from the other two groups. Consideration of the variances of activity ratings within the groups emphasizes the unique response of the health department directors and identifies activities characterized by considerable disagreement.
The study includes information necessary for researchers and practitioners to form an activity-based definition of varying scope. Definitions constructed from this information should be useful in planning the evaluation efforts that involve different groups of providers, since activities provide an objective basis for agreement. Repeating the approach outlined in the paper with other provider groups in other areas of the country should lead to better understanding of intergroup and regional differences in the concept of “primary care”.
Unable to display preview. Download preview PDF.
- 1.Reynolds RE: Primary care, ambulatory care, and family medicine: Overlapping but synonomous.J Med Educ 50: 893–895, 1975.Google Scholar
- 2.Governor's Task Force on Primary Care:Report of the Governor's Primary Care Task Force. Raleigh, North Carolina Department of Human Resources, March 1979.Google Scholar
- 3.Parker AW, Walsh JM, Coon M: A normative approach to the definition of primary health care.Milbank Mem Fund Q 54: 415–438, 1976.Google Scholar
- 4.Holmes C, Kane RL, Ford M, et al: Toward the measurement of primary care.Milbank Mem Fund Q 56: 231–252, 1978.Google Scholar
- 5.Aiken LH, Lewis CE, Craig J, et al: The contribution of specialists to the delivery of primary care: A new perspective.N Engl J Med 300: 1363–1370, 1979.Google Scholar
- 6.North American Primary Care Research Group: A glossary for primary care.J Fam Prac 5: 635–638, 1977.Google Scholar
- 7.Institute of Medicine: Primary care in medicine: A definition. Washington, DC, National Academy of Sciences, 1977.Google Scholar
- 8.Alpert JJ, Charney E: The education of physicians for primary care. DHEW Pub No (HRA) 74-3113, 1973.Google Scholar
- 9.Tonkin RS: Primary health care.Can J Public Health 67: 289–294, 1976.Google Scholar
- 10.Millis JS: Primary care: Definition of, and access to ...Nurs Outlook 25: 443–445, 1977.Google Scholar