Abstract

Significance. Patient satisfaction with medical care is one of the key performance indicators of the health care system. The purpose of the study: to conduct a comparative analysis of patient satisfaction with primary care provided by general practitioners (GP) and district physicians (DPh) in Russia and identify indicators that can be used to manage accessibility and quality of primary care, using the principles of value-based healthcare. Material and methods. The study used analytical, sociological and statistical methods. The survey was conducted by the method of sampling. The minimum sample size equaled to 400 observation units. The survey bases included medical organizations providing medical care on an outpatient basis in the cities of Moscow, Kemerovo and Belgorod, the places that have undergone reforming and introduced GP practices. Results. The final analysis included 415 questionnaires. Patient satisfaction with medical care, provided by GP equaled to 87.6%, satisfaction with care provided by DPh added up to 73.3% (p<0.001). Patient satisfaction with individual parameters of medical care related to the medical organization, doctor and doctor-patient relationship also turned out to be statistically significantly higher if provided by GP. The average score ranged within 3.8-4.2 and 2.2-2.4, respectively. For both the GP and DPh models of care delivery, the lowest satisfaction was reported for the parameters characterizing its organization. Based on the results of our own research and results of earlier papers, the indicators of primary care accessibility and quality that are of greatest value to the patient were identified. Conclusion. Based on generalization of the study results and data published in scientific literature, a set of indicators has been proposed to ensure continuous monitoring over quality and accessibility of primary care and make organizational and managerial decisions using the principles of value-based healthcare.

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