URBAN-RURAL DIFFERENCES IN THE LEVEL OF COMPETENCIES OF FAMILY PHYSICIANS IN TRANSITIONAL KOSOVO

Abstract

BACKGROUND: Skills and competencies of family physicians are a basic prerequisite for high-quality primary health care services. The aim of this survey was to assess urban-rural differences in the level of competencies of family physicians from patients’ perspective in transitional Kosovo. METHODS: A cross-sectional study was conducted in Kosovo in 2013 involving a nationwide sample of 1340 primary health care users aged ≥18 years (49% males and 51% females; overall age: 50.5±17.9 years; response rate: 89%). Patients were asked to rate the level of competencies of their family physicians regarding different domains of health services. The self-administered questionnaire included 37 items. Answers for each item of the tool ranged from one (“novice” physicians) to five (“expert” physicians). An overall summary score on the level of competencies of family physicians was calculated [range: from 37 (minimal competencies) to 185 (maximal competencies)]. Demographic and socioeconomic information was also collected. General Linear Model was used to compare urbanrural differences in the overall level of competencies of family physicians. RESULTS: Upon multivariable adjustment for demographic factors (age and sex), socioeconomic characteristics (education, income and employment), number of health visits in the past 12 months and the overall satisfaction with the quality of medical encounter, mean value of the overall summary score for the 37-item instrument was higher among rural residents compared with their urban counterparts (121 vs. 118, respectively, P=0.008). CONCLUSION: Our findings from Kosovo indicate that patients in rural areas perceive a significantly higher level of competencies of their family physicians compared with patients from urban areas. Determinants of such urban-rural differences should be further explored in future studies in Albanian settings. Keywords: competencies, family physicians, Kosovo, primary health care users, urban-rural differences.