Abstract
BackgroundGood patient experience is recognized as an important component of a strong primary care system. Among the dimensions related to experience in family medicine, the ability to cope better with health problems is considered to be a measure of the quality of a consultation with a family physician (FP). The objective is to identify factors related to patients, physicians and practice, associated with patients’ ability to cope better with their health problems after a family medicine consultation.MethodsThe data stemmed from the Swiss part of the Quality and Costs of Primary Care (QUALICOPC) study, an international cross sectional survey aiming to compare quality, cost and equity in primary care. In Switzerland, a random sample of 199 FPs and 1791 patients participated. The negative answer to the question: “After this visit, I feel I can cope better with my health problems” was modeled using multilevel logistic regressions.ResultsDifficulty to cope better with health problems was positively associated with the following: younger age (OR: 1.58, 95% CI [1.03–2.41]), cultural aspects related to the Swiss area of language (French speaking people declared higher inability than German and Italian ones), presence of chronic disease (OR: 1.54 95% CI [1.00–2.39]). Conversely an intermediate number (1–4) of visits during the last 6 months (OR: 0.37 95% CI [0.23–0.62]) and the satisfaction with the physician (OR: 0.18 95% CI [0.08–0.44]) are negative predictors of the patient inability to cope better with his health problems. A self-reported effort-reward imbalance at work (OR: 0.64 95% CI [0.41–1.00]) was the only predictive FP characteristic (negatively associated).ConclusionsAlthough the design of the study does not allow causal inference, this study showed that the predictors of patient difficulties to cope better with health problem are mainly centered on the patients’ characteristics. The patient-physician relationship both in terms of quality and frequency of visits is probably also important. Organizational practice characteristics do not seem to play a major role but stress at work among physicians should be further investigated.
Highlights
Good patient experience is recognized as an important component of a strong primary care system
Patient feeling of confidence and ability to cope with his health problems after a medical visit is, among many dimensions used to assess patient experience, considered as an interesting patient-reported outcome measure (PROM) [3,4,5,6]
According to some studies, physician exposure to stress at work could impact the quality of delivered care and patient experience [15, 16]
Summary
Good patient experience is recognized as an important component of a strong primary care system. Among the dimensions related to experience in family medicine, the ability to cope better with health problems is considered to be a measure of the quality of a consultation with a family physician (FP). The objective is to identify factors related to patients, physicians and practice, associated with patients’ ability to cope better with their health problems after a family medicine consultation. Patient feeling of confidence and ability to cope with his health problems after a medical visit (through the global concept of enablement) is, among many dimensions used to assess patient experience, considered as an interesting patient-reported outcome measure (PROM) [3,4,5,6]. According to some studies, physician exposure to stress at work could impact the quality of delivered care and patient experience [15, 16]. One study has explored potential links between patient enablement and FP burnout and reported negative results [17]
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