Patient experiences and the association with organizational factors in general practice: results from the Norwegian part of the international, multi-centre, cross-sectional QUALICOPC study.

Torunn Bjerve Eide,Hasse Melbye,Guri Rortveit,Irene Hetlevik,Elin Olaug Rosvold,Jørund Straand

doi:10.1186/s12913-016-1684-z

Abstract

BackgroundGeneral practitioners (GPs) constitute a vital part of a strong primary health care system. We need further knowledge concerning factors that may affect the patients’ experiences in their meetings with the GPs. We investigated to what degree organizational factors and GP characteristics are associated with patients’ communicative experiences in a consultation.MethodsWe used data from the Norwegian part of the international, multi-center study Quality and Costs of Primary Care in Europe (QUALICOPC). We included 198 Norwegian GPs and 1529 patients. The patients completed a survey concerning experiences in a consultation with a GP on the inclusion day. The GPs completed a survey regarding organizational aspects of their own practice. Main outcome measures were seven statements concerning how the patients experienced the communication with the GP during the consultation. A generalized estimating equation logistic regression model was used to identify variations in patient experiences associated with characteristics of the GPs and their practices.ResultsThe patients reported overall positive experiences with their GP consultations. Patients who consulted a GP with a short patient list were less likely than patients who consulted a GP with a medium sized list to regard the GP as polite (Odds Ratio (OR) 0.2; 95 % CI 0.1–0.7), to report that the GP asked questions about their health problems (OR 0.6; 0.4–1.0) or that the GP used sufficient time (OR 0.5; CI 0.3–0.9). Patients who consulted a GP with a long patient list compared to patients who consulted a GP with a medium sized list were less likely to feel that they could cope better after the GP visit (OR 0.5; 0.3–0.9) and more likely to feel that the GP hardly looked at them while talking (OR 1.8; 1.0–3.0). No associations with patient experiences were found with the average duration of the consultations, whether the GP worked in a fee-for-service model or whether the GP was the patient’s regular doctor.ConclusionsNorwegian patients report predominantly positive experiences when consulting a GP. Positive communication experiences are most likely to be reported when the GP has a medium sized patient list.

Highlights

General practitioners (GPs) constitute a vital part of a strong primary health care system
Most European health authorities have a common vision of a strong primary health care system, but there is substantial inter-country variation of the frame-work provided for the GPs’ work
The survey set consisted of: 1) A GP questionnaire concerning organisational aspects of the GP’s practice, the health problems and procedures handled in the practice and the range of medical equipment available for the GP. 2) A patient questionnaire concerning experiences with one specific GP consultation and with this GP’s practice, and concerning which health problems the patients expected the GP to be of help with

Summary

Introduction

General practitioners (GPs) constitute a vital part of a strong primary health care system. Reforms are frequently discussed or being implemented, and knowledge concerning aspects that may affect the quality of primary health care provision is of value to political decision-makers. Patients’ perceived satisfaction with the medical help they receive from their GP will to a large extent be coloured by the process-aspects, while it is more difficult for lay people to evaluate the medical quality and appropriateness of received care. Over the recent years the tendency has been to survey patients’ actual experiences instead of evaluating their more general satisfaction with health care services [7, 8]. We have scarce information on whether the organisational aspects of primary care may affect the patients’ experiences

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Conclusion