International Journal for Quality in Health Care 14:111-118 (2002)
© 2002 International Society for Quality in Health Care
Patient satisfaction with availability of general practice: an international comparison
1Centre for Quality of Care Research, University Medical Centre Nijmegen, The Netherlands
2Research Unit and Department of General Practice, Aarhus University, Denmark
3Department of Family Medicine, University Ljubljna, Slovenia
4Department of Population Studies and Social Science Research Methods, University of Ghent, Belgium
5AQUA Institute, Göttingen, Germany
6Centre for Primary Health Care Studies, University of Warwick, UK
7Department of General Practice, University of Oslo, Norway
8Centre Universitaire de Médecine Générale, Université Catholique de Louvain, Belgium
9SwissPEP, Programs for the Evaluation of Medical Practice, Gümlichen, Switzerland
10semFYC, Barcelona, Spain
11Centre for Quality of Care Research, University Medical Centre Nijmegen, The Netherlands
Address reprint requests to Michel Wensing WOK UMC Nijmegen PO Box 9101 6500 HB Nijmegen The Netherls. E-mail: M. Wensing{at}hsv.kun.nl
Objective. To identify associations between the characteristics of general practitioners and practices, and patients’ evaluations of the availability of general practice.
Design. Written surveys completed by patients.
Setting. General practice care in nine European countries: Denmark, Germany, The Netherlands, Norway, UK, Belgium (Flanders and Wallonia), Switzerland, Slovenia, and Spain.
Study participants. 15 996 adults patients consecutively visiting the general practitioner (response rates per country varied between 47 and 89%).
Main measures. The Europep instrument to assess patients’ evaluations of five aspects of the availability of general practice care: (1) getting an appointment, (2) getting through on the phone, (3) being able to speak to the practitioner on the telephone, (4) waiting time in the waiting room, and (5) providing quick services for urgent health problems. Each general practitioner recorded age, sex, number of years in the practice, number of practitioners and other care providers in the practice, and urbanization level of the practice.
Results. Patients’ more positive evaluations were associated with fewer general practitioners in the practice, except for quick services for urgent health problems (range of conditional overall odds ratios, 1.69–2.02). In addition, a number of significant unconditional overall odds ratios were found, particularly those related to the number of general practitioners’ working hours and the number of care providers in the practice. None of the associations was found consistently in all countries.
Conclusion. Patients favour small practices and full-time general practitioners, which contradicts developments in general practice in many countries. Policy makers should consider how the tensions between patients’ views and organizational developments can be solved.
Keywords: continuity, general practice, international comparison, patient satisfaction, primary health care
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