International Journal for Quality in Health Care Advance Access originally published online on December 23, 2007
International Journal for Quality in Health Care 2008 20(2):105-114; doi:10.1093/intqhc/mzm071
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Chronically ill Australians' satisfaction with accessibility and patient-centredness
1 Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
2 Discipline of General Practice, University of Adelaide, Adelaide, South Australia, Australia
3 Faculty of Health Sciences, University of Adelaide, Adelaide, South Australia, Australia
Objective. To evaluate the association of characteristics of patients and general practices with patient assessment of quality of care.
Design. Cross-sectional multi-practice study using the general practice assessment survey.
Settings. General practices in Australia.
Participants. Ninety-six general practices and 7505 chronic illness patients aged 
18 years.
Main outcome measures. Access of care and patient-centredness.
Results. Two factors were identified in factor analysis: ‘Access of care’ and ‘Patient-centredness’. Multilevel regression analysis showed significant associations between patients' assessments and patient and practice characteristics. Patients from smaller practices (one to three general practitioners) reported better access to care compared with larger practices. Patients from urban areas were more satisfied with patient-centredness than those from rural areas. Self-reported health status and age had a positive and home ownership, employment and education, and patients from non-English-speaking countries a negative relationship with both scores. Females were more satisfied with patient-centredness.
Conclusions. Patient assessments of quality of care and patient-centredness were strongly associated with practice and patient characteristics. This has important implications for interpreting assessments of the quality of primary care, and for policy and practice measures designed to improve this.
Keywords: general practice assessment survey, patient satisfaction with accessibility and patient-centredness, patient and practice characteristics, factor analysis, multilevel regression model, assessment of quality of primary care
Address reprint requests to: Upali Jayasinghe, Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia. E-mail: upali.jay{at}unsw.edu.au; upalij{at}optusnet.com.au
Accepted for publication November 22, 2007.