Purpose: The purpose of this study was to determine whether the clinic that is the site of data collection meets standards of providing primary care as measured by the Primary Care Assessment Survey (PCAS). Primary care characteristics are a set of provider activities that emphasize the importance of the relationship between the participant and the provider of care (IOM), 1996). The objectives of this research were to: (a) describe the primary care characteristics of a community-based clinic in an underserved area in Appalachia, (b) examine the relationships between primary care characteristics and socioeconomic factors, and; (c) examine the reliability and validity of the Primary Care Assessment Survey (PCAS). Design: Data for this cross-sectional survey (N=227) were collected over a four month period using face to face interviews at a not for profit community based clinic serving patients in three southern Appalachian states. Methods: The PCAS was used to measure 11 domains on primary care provider performance and was used to identify patients who had a regular provider of care and patients who did not have regular provider of care at the clinic. Findings: Patients who had a regular provider of care at the clinic were grouped (n=126) for comparison with those with no regular provider of care (n=98). Patients who had a regular provider of care reported lower proportions of major health conditions than the group with no provider of care, even though these participants were older, had higher levels of pain and lower (poorer) health perception. Participants in the group with no provider of care had greater proportions of major health conditions, with men in comparison with women having greater proportions of angina and liver disease. Educational level of patients was positively associated with provider thoroughness of examination and interpersonal treatment. Cronbach's coefficient alpha for the total scale was .74 after deleting one subscale. Factor analysis revealed one PCAS dimension, Communication accounting for 44% of the total variance. Interpersonal treatment and longitudinal continuity were predictors for comprehensive knowledge of the provider of care and accounted for 26% and 6% of the variance, respectively. Conclusions: The PCAS showed initial reliability and validity for underserved patients receiving care in community-based clinics. The findings suggest patients receiving care by a regular primary care provider may improve maintenance and prevention of major health conditions. Implications: The PCAS once modified for cultural context can be used to examine standards for providing primary care.
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