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Giraldo Osorio A, Vélez Álvarez C, Berra S, Perdomo Rubio A. Calidad de los instrumentos que valoran las funciones de la atención primaria : revisión sistemática. Hacia Promoc. Salud [Internet]. 1 de enero de 2020 [citado 30 de julio de 2025];25(1):109-2. Disponible en: https://revistasojs.ucaldas.edu.co/index.php/hacialapromociondelasalud/article/view/114
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Objetivo: evaluar las propiedades métricas de los instrumentos que valoran las funciones de la atención primaria en salud desde la perspectiva de usuarios. Métodos: revisión sistemática. Se utilizaron los descriptores “primary health care”, “questionnaires”, “psychometrics”, “outcome measurement” y “process measurement”. Los criterios de inclusión fueron publicaciones de revistas científicas en español, inglés y portugués, estudios de validación de cuestionarios que evaluaran funciones de la atención primaria en salud. Las propiedades métricas de los instrumentos se valoraron mediante el cuestionario EMPRO (por su sigla en inglés: Evaluating Measures of Patient Reported Outcomes). Resultados: se identificaron 28 artículos que cumplieron con los criterios de inclusión. Los cuestionarios que resultaron adecuados para su aplicación fueron 11, y de estos, ocho partían del PCAT (por su sigla en inglés: Primary Care Assessment Tool), ya que reunieron más evidencias sobre la calidad de sus propiedades métricas. Conclusiones: existen cuestionarios para evaluar las funciones esenciales de la atención primaria en salud. Las propiedades métricas del PCAT fueron adecuadas en la mayoría de las versiones adaptadas y validadas, por lo que permite obtener resultados confiables.
Citas
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2. Baumhauer JF. Patient-reported outcomes-are they living up to their potential. N Engl J Med. 2017; 377(1):6-9.
3. Pasarín Rua M, Berra S, Rajmil L, Solans M, Borrell C, Starfield B. Un instrumento para la evaluación de la atención primaria de salud desde la perspectiva de la población. Aten Primaria. 2007; 39(8):395-8.
4. Lévesque J-F, Haggerty J, Beninguissé G, Burge F, Gass D, Beaulieu M-D, et al. Mapping the coverage of attributes in validated instruments that evaluate primary healthcare from the patient perspective. BMC Family Practice. 2012; 13(1):20.
5. Valderas JM, Ferrer M, Mendívil J, Garin O, Rajmil L, Herdman M, et al. Development of EMPRO: A Tool for the Standardized Assessment of Patient‐Reported Outcome Measures. Value in Health. 2008; 11(4):700-8.
6. Garratt A, Schmidt L, Mackintosh A, Fitzpatrick R. Quality of life measurement: bibliographic study of patient assessed health outcome measures. BMJ. 2002; 324(7351):1417.
7. Valderas JM, Ferrer M, Alonso J. Instrumentos de medida de calidad de vida relacionada con la salud y de otros resultados percibidos por los pacientes. Medicina clínica. 2005; 125:56-60.
8. Macinko J, Guanais FC. Population experiences of primary care in 11 Organization for Economic Cooperation and Development countries. International Journal for Quality in Health Care. 2015; 27(6):443-50.
9. Ministerio de la Protección Social. Ley No. 1438 19 de enero de 2011. In: Cundinamarca, editor. Bogotá D.C2011.
10. Ferreira González I, Urrútia G, Alonso Coello P. Revisiones sistemáticas y metaanálisis: bases conceptuales e interpretación. Revista Española de Cardiología. 2011; 64(08):688-96.
11. Garin O, Herdman M, Vilagut G, Ferrer M, Ribera A, Rajmil L, et al. Assessing health-related quality of life in patients with heart failure: a systematic, standardized comparison of available measures. Heart failure reviews. 2014; (3):359-67.
12. Viera AJ, Garrett JM. Understanding interobserver agreement: the kappa statistic. Fam med. 2005; 37(5):360-3.
13. Giraldo-Osorio A. Instrumentos que valoran las funciones de la atención primaria de salud: perspectiva de los usuarios. Revista de Salud Pública. 2018; 20:498-504.
14. Lee Hargraves J, Hays RD, Cleary PD. Psychometric properties of the consumer assessment of health plans study (CAHPS®) 2.0 adult core survey. Health services research. 2003; 38(6p1):1509- 28.
15. Flocke SA. Measuring attributes of primary care: development of a new instrument. J Fam Pract. 1997; 45(1):64-74.
16. Grol RPTM, Wensing MJP, Olesem F. Patients evaluate general/family practice: the EUROPEP instrument: Task Force on Patient Evaluations of General Practice Care; 2000.
17. Haggerty JL, Roberge D, Freeman GK, Beaulieu C, Bréton M. Validation of a generic measure of continuity of care: when patients encounter several clinicians. Ann Fam Med. 2012; 10(5):443-51.
18. Mead N, Bower P, Roland M. The general practice assessment questionnaire (GPAQ)–development and psychometric characteristics. BMC family practice. 2008; 9(1):13.
19. Ramsay J, Campbell JL, Schroter S, Green J, Roland M. The General Practice Assessment Survey (GPAS): tests of data quality and measurement properties. Family Practice. 2000; 17(5):372-9.
20. Suhonen R, Välimäki M, Katajisto J. Developing and testing an instrument for the measurement of individual care. Journal of Advanced Nursing. 2000; 32(5):1253-63.
21. Stewart A, Nápoles Springer A, Pérez Stable E, Posner S, Bindman A, Howard L, et al. Interpersonal Processes of Care in Diverse Populations. The Milbank Quarterly. 1999; 77(3):305-39.
22. Meakin R, Weinman J. The ‘Medical Interview Satisfaction Scale’(MISS-21) adapted for British general practice. Family Practice. 2002; 19(3):257-63.
23. Himuro N, Kozuka N, Mori M. Measurement of family‐centred care: translation, adaptation and validation of the Measure of Processes of Care (MPOC‐56 and‐20) for use in Japan. Child: care, health and development. 2013; 39(3):358-65.
24. Glasgow RE, Wagner EH, Schaefer J, Mahoney LD, Reid RJ, Greene SM. Development and validation of the patient assessment of chronic illness care (PACIC). Medical care. 2005; 43(5):436-44.
25. Lee H, Choi Y, Sung N, Kim S, Chung S, Kim J, et al. Development of the Korean primary care assessment tool-measuring user experience: tests of data quality and measurement performance. Int J Qual Health Care. 2009; 21(2):103-8.
26. Starfield B, Cassady C, Nanda J, Forrest CB, Berk R. Consumer Experiences and Provider Perceptions of the Quality of Primary Care: Implications for Managed Care. The Journal of Family Practice. 1998; 46(3).
27. Shi L, Starfield B, Xu J. Validating the Adult Primary Care Assessment Tool. J Fam Pract. 2001; 50(2):161.
28. Cassady CE, Starfield B, Hurtado MP, Berk RA, Nanda JP, Friedenberg LA. Measuring consumer experiences with primary care. Pediatrics. 2000; 105 (Supp. 3):998-1003.
29. Berra S, Hauser L, Audisio Y, Mántaras J, Nicora V, Celestina de Oliveira MM, et al. Validez y fiabilidad de la versión argentina del PCAT-AE para evaluar la atención primaria de salud. Rev Panam Salud Publica. 2013; 33(1):30-9
30. Harzheim E, de Oliveira MMC, Agostinho MR, Hauser L, Stein AT, Gonçalves MR, et al. Validação do instrumento de avaliação da atenção primária à saúde: PCATool-Brasil adultos. Rev Bras Med Fam Comunidade. 2013; 8(29):274-84.
31. De Oliveira MMC, Harzheim E, Riboldi J, Duncan BB. PCATool-Adulto-Brasil: uma versão reduzida. Rev Bras Med Fam Comunidade. 2013; 8(29):256-63.
32. Harzheim E, Starfield B, Rajmil L, Álvarez-Dardet C, Stein AT. Consistência interna e confiabilidade da versão em português do Instrumento de Avaliação da Atenção Primária (PCATool-Brasil) para serviços de saúde infantil. Cad Saúde Pública. 2006; 22:1649-59.
33. Yang H, Shi L, Lebrun LA, Zhou X, Liu J, Wang H. Development of the Chinese primary care assessment tool: data quality and measurement properties. International Journal for Quality in Health Care. 2013; 25(1):92-105.
34. Rocha K, Rodríguez-Sanz M, Pasarín M, Berra S, Gotsens M, Borrell C. Assessment of primary care in health surveys: a population perspective. Eur J Public Health. 2011; 21(2):1-5.
35. Berra S, Rocha KB, Rodríguez-Sanz M, Pasarín MI, Rajmil L, Borrell C, et al. Properties of a short questionnaire for assessing Primary Care experiences for children in a population survey. BMC Public Health. 2011; 11(285).
36. Edvardsson D, Sandman PO, Rasmussen B. Swedish language Person‐centred Climate Questionnaire-patient version: construction and psychometric evaluation. JAN. 2008; 63(3):302-9.
37. Steine S, Finset A, Laerum E. A new, brief questionnaire (PEQ) developed in primary health care for measuring patients’ experience of interaction, emotion and consultation outcome. Family Practice. 2001; 18(4):410-8.
38. Vukovic M, Gvozdenovic BS, Gajic T, Stamatovic Gajic B, Jakovljevic M, McCormick BP. Validation of a patient satisfaction questionnaire in primary health care. Public Health. 2012; 126(8):710-8.
39. Marshall GN, Hays RD. The patient satisfaction questionnaire short-form (PSQ-18). Rand Santa Monica, CA; 1994.
40. Sánchez R, Echeverry J. Validación de escalas de medición en salud. Rev salud pública. 2004; 6(3):302-18.
2. Baumhauer JF. Patient-reported outcomes-are they living up to their potential. N Engl J Med. 2017; 377(1):6-9.
3. Pasarín Rua M, Berra S, Rajmil L, Solans M, Borrell C, Starfield B. Un instrumento para la evaluación de la atención primaria de salud desde la perspectiva de la población. Aten Primaria. 2007; 39(8):395-8.
4. Lévesque J-F, Haggerty J, Beninguissé G, Burge F, Gass D, Beaulieu M-D, et al. Mapping the coverage of attributes in validated instruments that evaluate primary healthcare from the patient perspective. BMC Family Practice. 2012; 13(1):20.
5. Valderas JM, Ferrer M, Mendívil J, Garin O, Rajmil L, Herdman M, et al. Development of EMPRO: A Tool for the Standardized Assessment of Patient‐Reported Outcome Measures. Value in Health. 2008; 11(4):700-8.
6. Garratt A, Schmidt L, Mackintosh A, Fitzpatrick R. Quality of life measurement: bibliographic study of patient assessed health outcome measures. BMJ. 2002; 324(7351):1417.
7. Valderas JM, Ferrer M, Alonso J. Instrumentos de medida de calidad de vida relacionada con la salud y de otros resultados percibidos por los pacientes. Medicina clínica. 2005; 125:56-60.
8. Macinko J, Guanais FC. Population experiences of primary care in 11 Organization for Economic Cooperation and Development countries. International Journal for Quality in Health Care. 2015; 27(6):443-50.
9. Ministerio de la Protección Social. Ley No. 1438 19 de enero de 2011. In: Cundinamarca, editor. Bogotá D.C2011.
10. Ferreira González I, Urrútia G, Alonso Coello P. Revisiones sistemáticas y metaanálisis: bases conceptuales e interpretación. Revista Española de Cardiología. 2011; 64(08):688-96.
11. Garin O, Herdman M, Vilagut G, Ferrer M, Ribera A, Rajmil L, et al. Assessing health-related quality of life in patients with heart failure: a systematic, standardized comparison of available measures. Heart failure reviews. 2014; (3):359-67.
12. Viera AJ, Garrett JM. Understanding interobserver agreement: the kappa statistic. Fam med. 2005; 37(5):360-3.
13. Giraldo-Osorio A. Instrumentos que valoran las funciones de la atención primaria de salud: perspectiva de los usuarios. Revista de Salud Pública. 2018; 20:498-504.
14. Lee Hargraves J, Hays RD, Cleary PD. Psychometric properties of the consumer assessment of health plans study (CAHPS®) 2.0 adult core survey. Health services research. 2003; 38(6p1):1509- 28.
15. Flocke SA. Measuring attributes of primary care: development of a new instrument. J Fam Pract. 1997; 45(1):64-74.
16. Grol RPTM, Wensing MJP, Olesem F. Patients evaluate general/family practice: the EUROPEP instrument: Task Force on Patient Evaluations of General Practice Care; 2000.
17. Haggerty JL, Roberge D, Freeman GK, Beaulieu C, Bréton M. Validation of a generic measure of continuity of care: when patients encounter several clinicians. Ann Fam Med. 2012; 10(5):443-51.
18. Mead N, Bower P, Roland M. The general practice assessment questionnaire (GPAQ)–development and psychometric characteristics. BMC family practice. 2008; 9(1):13.
19. Ramsay J, Campbell JL, Schroter S, Green J, Roland M. The General Practice Assessment Survey (GPAS): tests of data quality and measurement properties. Family Practice. 2000; 17(5):372-9.
20. Suhonen R, Välimäki M, Katajisto J. Developing and testing an instrument for the measurement of individual care. Journal of Advanced Nursing. 2000; 32(5):1253-63.
21. Stewart A, Nápoles Springer A, Pérez Stable E, Posner S, Bindman A, Howard L, et al. Interpersonal Processes of Care in Diverse Populations. The Milbank Quarterly. 1999; 77(3):305-39.
22. Meakin R, Weinman J. The ‘Medical Interview Satisfaction Scale’(MISS-21) adapted for British general practice. Family Practice. 2002; 19(3):257-63.
23. Himuro N, Kozuka N, Mori M. Measurement of family‐centred care: translation, adaptation and validation of the Measure of Processes of Care (MPOC‐56 and‐20) for use in Japan. Child: care, health and development. 2013; 39(3):358-65.
24. Glasgow RE, Wagner EH, Schaefer J, Mahoney LD, Reid RJ, Greene SM. Development and validation of the patient assessment of chronic illness care (PACIC). Medical care. 2005; 43(5):436-44.
25. Lee H, Choi Y, Sung N, Kim S, Chung S, Kim J, et al. Development of the Korean primary care assessment tool-measuring user experience: tests of data quality and measurement performance. Int J Qual Health Care. 2009; 21(2):103-8.
26. Starfield B, Cassady C, Nanda J, Forrest CB, Berk R. Consumer Experiences and Provider Perceptions of the Quality of Primary Care: Implications for Managed Care. The Journal of Family Practice. 1998; 46(3).
27. Shi L, Starfield B, Xu J. Validating the Adult Primary Care Assessment Tool. J Fam Pract. 2001; 50(2):161.
28. Cassady CE, Starfield B, Hurtado MP, Berk RA, Nanda JP, Friedenberg LA. Measuring consumer experiences with primary care. Pediatrics. 2000; 105 (Supp. 3):998-1003.
29. Berra S, Hauser L, Audisio Y, Mántaras J, Nicora V, Celestina de Oliveira MM, et al. Validez y fiabilidad de la versión argentina del PCAT-AE para evaluar la atención primaria de salud. Rev Panam Salud Publica. 2013; 33(1):30-9
30. Harzheim E, de Oliveira MMC, Agostinho MR, Hauser L, Stein AT, Gonçalves MR, et al. Validação do instrumento de avaliação da atenção primária à saúde: PCATool-Brasil adultos. Rev Bras Med Fam Comunidade. 2013; 8(29):274-84.
31. De Oliveira MMC, Harzheim E, Riboldi J, Duncan BB. PCATool-Adulto-Brasil: uma versão reduzida. Rev Bras Med Fam Comunidade. 2013; 8(29):256-63.
32. Harzheim E, Starfield B, Rajmil L, Álvarez-Dardet C, Stein AT. Consistência interna e confiabilidade da versão em português do Instrumento de Avaliação da Atenção Primária (PCATool-Brasil) para serviços de saúde infantil. Cad Saúde Pública. 2006; 22:1649-59.
33. Yang H, Shi L, Lebrun LA, Zhou X, Liu J, Wang H. Development of the Chinese primary care assessment tool: data quality and measurement properties. International Journal for Quality in Health Care. 2013; 25(1):92-105.
34. Rocha K, Rodríguez-Sanz M, Pasarín M, Berra S, Gotsens M, Borrell C. Assessment of primary care in health surveys: a population perspective. Eur J Public Health. 2011; 21(2):1-5.
35. Berra S, Rocha KB, Rodríguez-Sanz M, Pasarín MI, Rajmil L, Borrell C, et al. Properties of a short questionnaire for assessing Primary Care experiences for children in a population survey. BMC Public Health. 2011; 11(285).
36. Edvardsson D, Sandman PO, Rasmussen B. Swedish language Person‐centred Climate Questionnaire-patient version: construction and psychometric evaluation. JAN. 2008; 63(3):302-9.
37. Steine S, Finset A, Laerum E. A new, brief questionnaire (PEQ) developed in primary health care for measuring patients’ experience of interaction, emotion and consultation outcome. Family Practice. 2001; 18(4):410-8.
38. Vukovic M, Gvozdenovic BS, Gajic T, Stamatovic Gajic B, Jakovljevic M, McCormick BP. Validation of a patient satisfaction questionnaire in primary health care. Public Health. 2012; 126(8):710-8.
39. Marshall GN, Hays RD. The patient satisfaction questionnaire short-form (PSQ-18). Rand Santa Monica, CA; 1994.
40. Sánchez R, Echeverry J. Validación de escalas de medición en salud. Rev salud pública. 2004; 6(3):302-18.
