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Published in: BMC Primary Care 1/2014

Open Access 01-12-2014 | Research article

Decreasing trends in patient satisfaction, accessibility and continuity of care in Finnish primary health care – a 14-year follow-up questionnaire study

Authors: Risto Raivio, Juhani Jääskeläinen, Doris Holmberg-Marttila, Kari J Mattila

Published in: BMC Primary Care | Issue 1/2014

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Abstract

Background

The aim here was to explore trends in patient satisfaction with primary health care and its accessibility and continuity, and to explore whether through reforms and improvements some of the essential goals had been achieved over a 14-year period of time in Finland.

Methods

Nine questionnaire surveys were conducted over a period of 14 years among patients attending within one week in the 65 health centres in the Tampere University Hospital catchment area. A total of 147,394 responded out of a sample of 333,648 patients. The response rate varied yearly from 53% to 37%.

Results

Patient satisfaction with care in Finnish health centres decreased by nearly 9 percentage units from 1998 to 2011. The fall-off was most marked in the age-group over 64 years. There was a 20 percentage unit’s reduction in ease of access as reported by patients. Respondents also reported that the continuity of care had deteriorated.

Conclusions

Despite major reforms in Finnish health care policy, patients seem to be less satisfied. Our findings challenge both Finnish authorities and GPs to improve the accessibility and continuity of care in primary health services.
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Literature
1.
go back to reference Bower P, Roland M, Campbell J, Mead N: Setting standards based on patients’ views on access and continuity: secondary analysis of data from general practice assessment survey. BMJ. 2003, 326: 258-10.1136/bmj.326.7383.258.CrossRefPubMedPubMedCentral Bower P, Roland M, Campbell J, Mead N: Setting standards based on patients’ views on access and continuity: secondary analysis of data from general practice assessment survey. BMJ. 2003, 326: 258-10.1136/bmj.326.7383.258.CrossRefPubMedPubMedCentral
2.
go back to reference Guthrie B, Saultz B, Freeman JW, Freeman GK, Haggerty JL: Continuity of care matters. BMJ. 2008, 337: 867-10.1136/bmj.a867.CrossRef Guthrie B, Saultz B, Freeman JW, Freeman GK, Haggerty JL: Continuity of care matters. BMJ. 2008, 337: 867-10.1136/bmj.a867.CrossRef
3.
go back to reference Mead N, Bower P, Roland M: Factors associated with enablement in general practice: cross-sectional study using routinely-collected data. Br J Gen Pract. 2008, 58 (550): 346-352. 10.3399/bjgp08X280218.CrossRefPubMedPubMedCentral Mead N, Bower P, Roland M: Factors associated with enablement in general practice: cross-sectional study using routinely-collected data. Br J Gen Pract. 2008, 58 (550): 346-352. 10.3399/bjgp08X280218.CrossRefPubMedPubMedCentral
4.
go back to reference Grol R: Measuring performance quality in general practice: is international harmonization desirable?. Br J Gen Pract. 2007, 57: 691-692.PubMedPubMedCentral Grol R: Measuring performance quality in general practice: is international harmonization desirable?. Br J Gen Pract. 2007, 57: 691-692.PubMedPubMedCentral
5.
go back to reference Grol R, Wensing M, Mainz J, Ferreira P, Hearnshaw H, Hjortdahl P, Olesen F, Ribacke M, Spenser T, Szécsényi J: Patients’ priorities with respect to general practice care: an international comparison. Fam Pract. 1999, 16: 4-11. 10.1093/fampra/16.1.4.CrossRefPubMed Grol R, Wensing M, Mainz J, Ferreira P, Hearnshaw H, Hjortdahl P, Olesen F, Ribacke M, Spenser T, Szécsényi J: Patients’ priorities with respect to general practice care: an international comparison. Fam Pract. 1999, 16: 4-11. 10.1093/fampra/16.1.4.CrossRefPubMed
6.
go back to reference Vedstedt P, Mainz J, Lauritzen T, Olesen F: Patient and GP agreement on aspects of general practice care. Fam Pract. 2002, 19: 339-343. 10.1093/fampra/19.4.339.CrossRef Vedstedt P, Mainz J, Lauritzen T, Olesen F: Patient and GP agreement on aspects of general practice care. Fam Pract. 2002, 19: 339-343. 10.1093/fampra/19.4.339.CrossRef
7.
go back to reference Thompson K, Parahoo K, Farrell B: An evaluation of GP out-of-hours service: meeting patient expectations of care. J Eval Clin Pract. 2003, 10: 467-474.CrossRef Thompson K, Parahoo K, Farrell B: An evaluation of GP out-of-hours service: meeting patient expectations of care. J Eval Clin Pract. 2003, 10: 467-474.CrossRef
8.
go back to reference Starfield B, Shi L: Policy relevant determinants of health: an international perspective. Health Policy. 2002, 60 (3): 201-218. 10.1016/S0168-8510(01)00208-1. JunCrossRefPubMed Starfield B, Shi L: Policy relevant determinants of health: an international perspective. Health Policy. 2002, 60 (3): 201-218. 10.1016/S0168-8510(01)00208-1. JunCrossRefPubMed
13.
go back to reference Kunta- ja palvelurakenneuudistus (PARAS). Municipal and Service Reform to Assure Equal Social and Health Services for All Residents. Ministry of Social Affairs and Health, Finland. Text available only in Finnish). http://www.stm.fi/en/frontpage (accessed 30 Apr 2013 Kunta- ja palvelurakenneuudistus (PARAS). Municipal and Service Reform to Assure Equal Social and Health Services for All Residents. Ministry of Social Affairs and Health, Finland. Text available only in Finnish). http://​www.​stm.​fi/​en/​frontpage (accessed 30 Apr 2013
15.
go back to reference Gerard K, Salisbury C, Street D, Pope C, Baxter H: Is fast access to general practice all that should matter? A discrete choice experiment of patients’ preferences. J Health Serv Res Policy. 2008, 13 (Suppl 2): 3-10. 10.1258/jhsrp.2007.007087. AprCrossRefPubMed Gerard K, Salisbury C, Street D, Pope C, Baxter H: Is fast access to general practice all that should matter? A discrete choice experiment of patients’ preferences. J Health Serv Res Policy. 2008, 13 (Suppl 2): 3-10. 10.1258/jhsrp.2007.007087. AprCrossRefPubMed
16.
go back to reference Nutting PA, Goodwin MA, Flocke SA, Zyzanski SJ, Stange KC: Continuity of primary care: to whom does it matter and when?. Ann Fam Med. 2003, 1 (3): 149-155. 10.1370/afm.63.CrossRefPubMedPubMedCentral Nutting PA, Goodwin MA, Flocke SA, Zyzanski SJ, Stange KC: Continuity of primary care: to whom does it matter and when?. Ann Fam Med. 2003, 1 (3): 149-155. 10.1370/afm.63.CrossRefPubMedPubMedCentral
18.
go back to reference Raivio R, Jääskeläinen J, Holmberg-Marttila D, Mattila K: Assessment of patient satisfaction in primary health care – reliable information and benchmarking. Finnish Medical Journal. 2008, 63; 33: 2623-2626. Text in Finnish, summary in English Raivio R, Jääskeläinen J, Holmberg-Marttila D, Mattila K: Assessment of patient satisfaction in primary health care – reliable information and benchmarking. Finnish Medical Journal. 2008, 63; 33: 2623-2626. Text in Finnish, summary in English
19.
go back to reference Allan J, Schattner P, Stocks N, Ramsay E: Does patient satisfaction of general practice change over decade?. BMC Fam Pract. 2009, 8: 10-13. Allan J, Schattner P, Stocks N, Ramsay E: Does patient satisfaction of general practice change over decade?. BMC Fam Pract. 2009, 8: 10-13.
20.
go back to reference Lurås H: The association between patient shortage and patient satisfaction with general practioners. Scand J Prim Health Care. 2007, 25: 133-139. 10.1080/02813430701286579.CrossRefPubMedPubMedCentral Lurås H: The association between patient shortage and patient satisfaction with general practioners. Scand J Prim Health Care. 2007, 25: 133-139. 10.1080/02813430701286579.CrossRefPubMedPubMedCentral
21.
go back to reference Mäntyselkä P, Halonen P, Vehviläinen A, Takala J, Kumpusalo E: Access to and continuity of primary medical care of different providers as perceived by the Finnish population. Scand J Prim Health Care. 2007, 25: 27-32. 10.1080/02813430601061106.CrossRefPubMedPubMedCentral Mäntyselkä P, Halonen P, Vehviläinen A, Takala J, Kumpusalo E: Access to and continuity of primary medical care of different providers as perceived by the Finnish population. Scand J Prim Health Care. 2007, 25: 27-32. 10.1080/02813430601061106.CrossRefPubMedPubMedCentral
22.
go back to reference Agarwal G, Crooks V: The nature of informational continuity of care in general practice. Br J Gen Pract. 2008, 58 (556): 784-789.CrossRef Agarwal G, Crooks V: The nature of informational continuity of care in general practice. Br J Gen Pract. 2008, 58 (556): 784-789.CrossRef
23.
go back to reference Williams S, Weinman J, Dale J: Doctor-patient communication and patient satisfaction: A review. Fam Pract. 1998, 15 (5): 480-492. 10.1093/fampra/15.5.480.CrossRefPubMed Williams S, Weinman J, Dale J: Doctor-patient communication and patient satisfaction: A review. Fam Pract. 1998, 15 (5): 480-492. 10.1093/fampra/15.5.480.CrossRefPubMed
24.
go back to reference Kokko S: News from the Nordic colleges of general practitioners: Developments in Finnish general practice. Scand J Prim Health Care. 2006, 24 (1): 1-2. MarCrossRefPubMed Kokko S: News from the Nordic colleges of general practitioners: Developments in Finnish general practice. Scand J Prim Health Care. 2006, 24 (1): 1-2. MarCrossRefPubMed
25.
go back to reference Kokko S: Towards fragmentation of general practice and primary healthcare in Finland?. Scand J Prim Health Care. 2007, 25 (3): 131-132. 10.1080/02813430701576482. SepCrossRefPubMedPubMedCentral Kokko S: Towards fragmentation of general practice and primary healthcare in Finland?. Scand J Prim Health Care. 2007, 25 (3): 131-132. 10.1080/02813430701576482. SepCrossRefPubMedPubMedCentral
26.
go back to reference Parmanne P, Saukkonen S-M, Ruskoaho J, Vuorio S: Lack of physicians delaying treatment in health centres. Finnish Medical Journal. 2010, 65; 48 (48): 3989-3994. Text in Finnish, summary in English Parmanne P, Saukkonen S-M, Ruskoaho J, Vuorio S: Lack of physicians delaying treatment in health centres. Finnish Medical Journal. 2010, 65; 48 (48): 3989-3994. Text in Finnish, summary in English
27.
go back to reference Coulter A, Jenkinson C: European patients’ views on the responsiveness of health systems and healthcare providers. Eur J Public Health. 2005, 15 (4): 355-360. 10.1093/eurpub/cki004. AugustCrossRefPubMed Coulter A, Jenkinson C: European patients’ views on the responsiveness of health systems and healthcare providers. Eur J Public Health. 2005, 15 (4): 355-360. 10.1093/eurpub/cki004. AugustCrossRefPubMed
29.
go back to reference Oprea L, Braunack-Mayer A, Rogers WA, Stocks N: An ethical justification for the Chronic Care Model (CCM). Health Expect. 2010, 13 (1): 55-64. 10.1111/j.1369-7625.2009.00581.x. MarCrossRefPubMed Oprea L, Braunack-Mayer A, Rogers WA, Stocks N: An ethical justification for the Chronic Care Model (CCM). Health Expect. 2010, 13 (1): 55-64. 10.1111/j.1369-7625.2009.00581.x. MarCrossRefPubMed
31.
go back to reference Anell A: Choice and privatisation in Swedish primary health care. Health Econ Policy Law. 2010, 12: 1-21. Aug Anell A: Choice and privatisation in Swedish primary health care. Health Econ Policy Law. 2010, 12: 1-21. Aug
Metadata
Title
Decreasing trends in patient satisfaction, accessibility and continuity of care in Finnish primary health care – a 14-year follow-up questionnaire study
Authors
Risto Raivio
Juhani Jääskeläinen
Doris Holmberg-Marttila
Kari J Mattila
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2014
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-15-98

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