Abstract
IntroductionPrimary care (PC) is the provision of universally accessible, integrated, person-centred, comprehensive health and community services. Professionals active in primary care teams include family physicians and general practitioners (FP/GPs). There is concern in Slovenia that the current economic crisis might change the nature of PC services. Access, one of the most basic requirements of general practice, is universal in Slovenia, which is one of the smallest European countries; under national law, compulsory health insurance is mandatory for its citizens. Our study examined access to PC in Slovenia during a time of economic crisis as experienced and perceived by patients between 2011 and 2012, and investigated socio-demographic factors affecting access to PC in Slovenia.MethodsData were collected as a part of a larger international study entitled Quality and Costs of Primary Care in Europe (QUALICOPC) that took place during a period of eight months in 2011 and 2012. 219 general practices were included; in each, the aim was to evaluate 10 patients. Dependent variables covered five aspects of access to PC: communicational, cultural, financial, geographical and organizational. 15 socio-demographic factors were investigated as independent variables. Descriptive statistics, factor analysis and multilevel analysis were applied.ResultsThere were 1,962 patients in the final sample, with a response rate of 89.6%. The factors with the most positive effect on access to PC were financial and cultural; the most negative effects were caused by organizational problems. Financial difficulties were not a significant socio-demographic factor. Greater frequency of visits improves patients’ perception of communicational and cultural access. Deteriorating health conditions are expected to lower perceived geographical access. Patients born outside Slovenia perceived better organizational access than patients born in Slovenia.ConclusionsUniversal medical insurance in Slovenia protects most patients from PC inaccessibility. However, problems perceived by patients may indicate the need for changes in the organization of PC.Electronic supplementary materialThe online version of this article (doi:10.1186/s12939-015-0166-y) contains supplementary material, which is available to authorized users.
Highlights
Primary care (PC) is the provision of universally accessible, integrated, person-centred, comprehensive health and community services
Our study explored patients’ experiences and perceptions of access to PC in Slovenia
The average patient age was 48.7±16.9 years. Most patients and their mothers were born in Slovenia. 11.5% of patients were born outside Slovenia, while 17.2% reported that their mother’s country of birth was a country other than Slovenia
Summary
Primary care (PC) is the provision of universally accessible, integrated, person-centred, comprehensive health and community services. The Expert Panel of the European Commission has recently formulated an up-to-date concept of primary (health) care. Under this definition, universally accessible, integrated, person-centred, comprehensive health and community services must be provided by a team of professionals. Kert et al International Journal for Equity in Health (2015) 14:39 able to address most personal health needs These services are to be delivered in a sustained partnership between patients and formal caregivers, in the context of family and community, and play a central role in the overall coordination and continuity of people’s health care needs. Equality in health care is one of the crucial features that quality PC should have [8]; the outcome of a PC system includes three dimensions: quality of care; efficiency of care; and equity in health [7]
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