Measuring comprehensiveness of care using the Primary Care Assessment Tool: systematic review

Tolazzi et al.


To assess the comprehensiveness of primary healthcare (PHC) in different countries.


PubMed, Virtual Health Library (BVS), and Scopus were systematically searched. Observational studies published from 2017 to 2019, using the Adult Primary Care Assessment Tool (PCAT) to assess comprehensiveness were included without limits regarding the language of publication or country. The quality of studies was assessed using the Newcastle-Ottawa scale (NOS).


Of 124 articles initially selected, 13 were included: four from China, two from Japan, and two from Vietnam; considering the Americas, all four studies were performed in Brazil. Only one study from Africa, performed in Malawi, was included. The quality of studies according to the NOS was acceptable. Considering the availability of services, eight facilities had low comprehensiveness, vs. five with high comprehensiveness. Considering the services performed at the facility, nine had low comprehensiveness, and only four had high comprehensiveness.


The low degree of PHC orientation in terms of comprehensiveness in terms of both services performed and services provided may reflect a lack of understanding of the demands of users, and indicates the need for concrete action to strengthen PHC as the basis of healthcare systems.

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