TABLE 1.

Operational definitions of attributes of primary healthcare to be evaluated and consensus on best data source for evaluation

Core Attributes	Best Data Source
First-Contact Accessibility: The ease with which a person can obtain needed care (including advice and support) from the practitioner of choice within a time frame appropriate to the urgency of the problem.	Patient
Comprehensiveness of Services: The provision, either directly or indirectly, of a full range of services to meet patients' healthcare needs. This includes health promotion, prevention, diagnosis and treatment of common conditions, referral to other providers, management of chronic conditions, rehabilitation, palliative care and, in some models, social services.	Patient, provider, administrative data
Relational Continuity: A therapeutic relationship between a patient and one or more providers that spans various healthcare events and results in accumulated knowledge of the patient and care consistent with the patient's needs.	Patient
Coordination (Management) Continuity: The delivery of services by different providers in a timely and complementary manner such that care is connected and coherent.	Patient
Interpersonal Communication: The ability of the provider to elicit and understand patient concerns, to explain healthcare issues and engage in shared decision-making, if desired.	Patient
Technical Quality of Clinical Care: The degree to which clinical procedures reflect current research evidence and/or meet commonly accepted standards for technical content or skill.	Provider, chart audit
Clinical Information Management: The adequacy of methods and systems to capture, update, retrieve and monitor patient data in a timely, pertinent and confidential manner.	Provider
Person-Oriented Dimensions
Advocacy: The extent to which providers represent the best interests of individual patients and patient groups in matters of health (including broad determinants) and healthcare.	Patient
Cultural Sensitivity: The extent to which a provider integrates cultural considerations into communication, assessment, diagnosis and treatment planning.	Patient
Family-Centred Care: The extent to which the provider considers the family (in all its expressions), understands its influence on a person's health and engages it as a partner in ongoing healthcare.	Patient
Respectfulness: The extent to which health professionals and support staff meet users' expectations about interpersonal treatment, demonstrate respect for the dignity of patients and provide adequate privacy.	Patient
Whole-Person Care: The extent to which a provider elicits and considers the physical, emotional and social aspects of a patient's health and considers the community context in the patient's care.	Patient
Community-Oriented Dimensions
Client/Community Participation: The involvement of clients and community members in decisions regarding the structure of the practice and services provided (e.g., advisory committees, community governance).	Patient, provider
Equity: The extent to which access to healthcare and good-quality services is provided on the basis of health needs, without systematic differences on the basis of individual or social characteristics.	All
Intersectoral Team: The extent to which the primary care provider collaborates with practitioners from non-health sectors in providing services that influence health. (Note: This dimension is relevant only to community models of primary care.)	Provider
Population Orientation: The extent to which primary care providers assess and respond to the health needs of the population they serve. (In professional models, the population is the patient population served; in community models, it is defined by geography or social characteristics.)	Patient, provider
Structural Dimensions
Accessibility–Accommodation: The way primary healthcare resources are organized to accommodate a wide range of patients' abilities to contact healthcare providers and reach healthcare services (e.g., the organization of characteristics such as telephone services, flexible appointment systems, hours of operation and walk-in periods).	Patient
Informational Continuity*: The extent to which information about past care is used to make current care appropriate to the patient.	(Not assessed)
Multidisciplinary Team: Practitioners from various health disciplines collaborate in providing ongoing healthcare.	Provider
Quality Improvement Process: The institutionalization of policies and procedures that provide feedback about structures and practices and that lead to improvements in clinical quality of care and provide assurance of safety.	Provider
System Integration: The extent to which the healthcare unit organization has established and maintains linkages with other parts of the healthcare and social services system to facilitate transfer of care and coordinate concurrent care among different healthcare organizations.	Provider
System Performance
Accountability: The extent to which the responsibilities of professionals, management and governance structures are defined, their performance is monitored and appropriate information on results is made available to stakeholders.	Provider
Availability: The fit between the number and type of human and physical resources and the volume and types of care required by the catchment population served in a defined period of time.	Administrative data
Efficiency/Productivity: Achieving the desired results with the most cost-effective use of resources. (This definition is non-operational.)	Administrative data

^*This definition and best data source were not submitted to the consensus process but are included for completeness by general agreement of the research team.