How do chronically ill patients evaluate their medical care? An observational study with 46919 patients in 676 primary care practices of direct relevance to person-centered medicine

Abstract

Objectives: Patients’ evaluation of medical care presents an essential dimension within the quality of care. The purpose of this study was to determine whether an association exists between patients’ self-reported chronic conditions and their evaluation of medical care.Method: Study participants included 46919 patients from 676 primary care practices in Germany who completed the EUROPEP questionnaire consisting of 23 items with 5 dimensions: “Relationship and communication”, “medical care”, “information and support”, “continuity and cooperation”, and “availability and accessibility”. The primary outcome measure was the presence of a self-reported chronic condition (yes vs. no). Unpaired t-tests were used to test for differences between patients with and without chronic conditions with respect to EUROPEP items. Furthermore, a log-binomial regression model on patients’ self-reported chronic conditions was calculated.Results: Survey respondent rate was 92.5%. Over 45.6% of patients reported having a chronic condition. In general, patients with and without chronic conditions evaluated their care as positive. Self-reported chronic conditions were associated with two items from “relationship and communication”, two items from “medical care”, and one item from “facilities availability and accessibility”. Items from “information and support” and “continuity and cooperation” were not associated with self-reported chronic conditions.Conclusions: The study confirmed a high level of patients’ evaluation of medical care provided by general practices and that while patients with a self-reported chronic condition report generally higher satisfaction, this is not the case for all aspects of care. The results are important for understanding patients’ priorities with regard to general practice care and are advanced as major contributions to the development of person-centered medicine.