Practice Features Associated With Patient- Reported Accessibility, Continuity, and Coordination of Primary Health Care

PURPOSE On the eve of major primary health care reforms, we conducted a mul-tilevel survey of primary health care clinics to identify attributes of clinic organi-zation and physician practice that predict accessibility, continuity, and coordina-tion of care as experienced by patients. METHODS Primary health care clinics were selected by stratifi ed random sampling in urban, suburban, rural, and remote locations in Quebec, Canada. Up to 4 fam-ily or general physicians were selected in each clinic, and 20 patients seeing each physician used the Primary Care Assessment Tool to report on fi rst-contact accessi-bility (being able to obtain care promptly for sudden illness), relational continuity (having an ongoing relationship with a physician who knew their particulars), and coordination continuity (having coordination between their physician and special-ists). Physicians reported on aspects of their practice, and secretaries and directors reported on organizational features of the clinic. We used hierarchical regression modeling on the subsample of regular patients at the clinic