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Published in: BMC Health Services Research 1/2007

Open Access 01-12-2007 | Research article

Doctor and practice characteristics associated with differences in patient evaluations of general practice

Authors: Hanne N Heje, Peter Vedsted, Ineta Sokolowski, Frede Olesen

Published in: BMC Health Services Research | Issue 1/2007

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Abstract

Background

Variation in patients' evaluation due to general practitioner (GP) and practice factors may provide information useful in a quality improvement context. However, the extent to which differences in patients' evaluation of the GPs are associated with differences in GP and practice characteristics must also be ascertained in order to facilitate comparison of adjusted patient evaluations between GPs. The aim of this study was to determine such associations in a setting where GPs serve a list of patients and act as gatekeepers.

Methods

We carried out a patient evaluation survey among voluntarily participating GPs using the EUROPEP questionnaire, which produced 28,260 patient evaluations (response rate 77.3%) of 365 GPs. In our analyses we compared the prevalence of positive evaluations in groups of GPs.

Results

Our principal finding was a negative association between the GP's age and the evaluation of all aspects, except accessibility. We also found an association between the way the practice was organised and the patients' evaluation of accessibility, with GPs in single-handed practices getting far the most positive evaluations. Long weekly working hours were associated with more positive evaluations of all dimensions except accessibility, whereas more than 0.5 full-time employees per GP, a higher number of listed patients per GP and working in a training practice were associated with negative evaluation of accessibility.

Conclusion

GP characteristics are mainly associated with patients' experience of interpersonal aspects of care, while practice characteristics are associated with evaluation of accessibility. These differences need to be accounted for when comparing patient evaluations of different practices.
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Literature
1.
go back to reference Measurement of patients' satisfaction with their care. 1993, London: Royal College of Physicians of London, 1 Measurement of patients' satisfaction with their care. 1993, London: Royal College of Physicians of London, 1
2.
go back to reference Jung HP: Quality of care in general practice. The patient perspective [thesis]. 1999, Nijmegen: University of Nijmegen, University of Maastricht Jung HP: Quality of care in general practice. The patient perspective [thesis]. 1999, Nijmegen: University of Nijmegen, University of Maastricht
3.
go back to reference O'Riordan M, Seuntjens L, Grol R, (editors): Improving patient care in primary care in Europe. 2004, Netherland: EQuiP, 1 O'Riordan M, Seuntjens L, Grol R, (editors): Improving patient care in primary care in Europe. 2004, Netherland: EQuiP, 1
4.
go back to reference Perneger TV: Adjustment for patient characteristics in satisfaction surveys. Int J Qual Health Care. 2004, 16: 433-435. 10.1093/intqhc/mzh090.CrossRef Perneger TV: Adjustment for patient characteristics in satisfaction surveys. Int J Qual Health Care. 2004, 16: 433-435. 10.1093/intqhc/mzh090.CrossRef
5.
go back to reference Baker R, Streatfield J: What type of general practice do patients prefer? Exploration of practice characteristics influencing patient satisfaction. Br J Gen Pract. 1995, 45: 654-659.PubMedPubMedCentral Baker R, Streatfield J: What type of general practice do patients prefer? Exploration of practice characteristics influencing patient satisfaction. Br J Gen Pract. 1995, 45: 654-659.PubMedPubMedCentral
6.
go back to reference Baker R: Characteristics of practices, general practitioners and patients related to levels of patients' satisfaction with consultations. Br J Gen Pract. 1996, 46: 601-605.PubMedPubMedCentral Baker R: Characteristics of practices, general practitioners and patients related to levels of patients' satisfaction with consultations. Br J Gen Pract. 1996, 46: 601-605.PubMedPubMedCentral
7.
go back to reference Kvamme OJ, Sandvik L, Hjortdahl P: [Practice patterns, physicians' characteristics and patient-evaluated quality of general practice in Norway] (in Norwegian). Tidsskr Nor Laegeforen. 2000, 120: 2499-2502.PubMed Kvamme OJ, Sandvik L, Hjortdahl P: [Practice patterns, physicians' characteristics and patient-evaluated quality of general practice in Norway] (in Norwegian). Tidsskr Nor Laegeforen. 2000, 120: 2499-2502.PubMed
8.
go back to reference Campbell JL, Ramsay J, Green J: Practice size: impact on consultation length, workload, and patient assessment of care. Br J Gen Pract. 2001, 51: 644-650.PubMedPubMedCentral Campbell JL, Ramsay J, Green J: Practice size: impact on consultation length, workload, and patient assessment of care. Br J Gen Pract. 2001, 51: 644-650.PubMedPubMedCentral
9.
go back to reference Lin HC, Xirasagar S, Laditka JN: Patient perceptions of service quality in group versus solo practice clinics. Int J Qual Health Care. 2004, 16: 437-445. 10.1093/intqhc/mzh072.CrossRef Lin HC, Xirasagar S, Laditka JN: Patient perceptions of service quality in group versus solo practice clinics. Int J Qual Health Care. 2004, 16: 437-445. 10.1093/intqhc/mzh072.CrossRef
10.
go back to reference van den Hombergh P, Engels Y, van den Hoogen H, van Doremalen J, van den Bosch W, Grol R: Saying 'goodbye' to single-handed practices; what do patients and staff lose or gain?. Fam Pract. 2005, 22: 20-27. 10.1093/fampra/cmh714.CrossRef van den Hombergh P, Engels Y, van den Hoogen H, van Doremalen J, van den Bosch W, Grol R: Saying 'goodbye' to single-handed practices; what do patients and staff lose or gain?. Fam Pract. 2005, 22: 20-27. 10.1093/fampra/cmh714.CrossRef
11.
go back to reference Wensing M, Vedsted P, Kersnik J, Peersman W, Klingenberg A, Hearnshaw H, Hjortdahl P, Paulus D, Künzi B, Mendive J, Grol R: Patient satisfaction with availability of general practice: an international comparison. Int J Qual Health Care. 2002, 14: 111-118.CrossRef Wensing M, Vedsted P, Kersnik J, Peersman W, Klingenberg A, Hearnshaw H, Hjortdahl P, Paulus D, Künzi B, Mendive J, Grol R: Patient satisfaction with availability of general practice: an international comparison. Int J Qual Health Care. 2002, 14: 111-118.CrossRef
12.
go back to reference Hjortdahl P, Laerum E: Continuity of care in general practice: effect on patient satisfaction. BMJ. 1992, 304: 1287-1290.CrossRef Hjortdahl P, Laerum E: Continuity of care in general practice: effect on patient satisfaction. BMJ. 1992, 304: 1287-1290.CrossRef
13.
go back to reference Baker R, Mainous AG, Gray DP, Love MM: Exploration of the relationship between continuity, trust in regular doctors and patient satisfaction with consultations with family doctors. Scand J Prim Health Care. 2003, 21: 27-32. 10.1080/02813430310002995.CrossRef Baker R, Mainous AG, Gray DP, Love MM: Exploration of the relationship between continuity, trust in regular doctors and patient satisfaction with consultations with family doctors. Scand J Prim Health Care. 2003, 21: 27-32. 10.1080/02813430310002995.CrossRef
14.
go back to reference Grol R, Wensing M: Patients evaluate general/family practice. The EUROPEP instrument. 2000, EQuiP, WONCA Region Europe Grol R, Wensing M: Patients evaluate general/family practice. The EUROPEP instrument. 2000, EQuiP, WONCA Region Europe
15.
go back to reference Grol R, Wensing M, Mainz J, Jung HP, Ferreira P, Hearnshaw H, Hjortdahl P, Olesen F, Reis S, Ribacke M, Szecsenyi J: Patients in Europe evaluate general practice care: an international comparison. Br J Gen Pract. 2000, 50: 882-887.PubMedPubMedCentral Grol R, Wensing M, Mainz J, Jung HP, Ferreira P, Hearnshaw H, Hjortdahl P, Olesen F, Reis S, Ribacke M, Szecsenyi J: Patients in Europe evaluate general practice care: an international comparison. Br J Gen Pract. 2000, 50: 882-887.PubMedPubMedCentral
16.
go back to reference Bjørner JB, Damsgaard MT, Watt T, Bech P, Rasmussen NK, Kristensen TS, Modvig J, Thunedborg K: [The Danish manual for SF-36. A health status questionnaire]. 1997, Copenhagen: Lif, (in Danish) Bjørner JB, Damsgaard MT, Watt T, Bech P, Rasmussen NK, Kristensen TS, Modvig J, Thunedborg K: [The Danish manual for SF-36. A health status questionnaire]. 1997, Copenhagen: Lif, (in Danish)
17.
go back to reference Lamberts H, Wood M: ICPC. [International Classification for Primary Care] (Danish version). 1990, Oxford Medical Publications Lamberts H, Wood M: ICPC. [International Classification for Primary Care] (Danish version). 1990, Oxford Medical Publications
18.
go back to reference Clayton D, Hills M: Statistical Models in Epidemiology. 1993, Oxford: Oxford University Press Clayton D, Hills M: Statistical Models in Epidemiology. 1993, Oxford: Oxford University Press
19.
go back to reference Modern Epidemiology. 1998, Philadelphia: Lippicott-Raven Publishers, Second Modern Epidemiology. 1998, Philadelphia: Lippicott-Raven Publishers, Second
20.
go back to reference Barros AJ, Hirakata VN: Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol. 2003, 3: 21-10.1186/1471-2288-3-21.CrossRef Barros AJ, Hirakata VN: Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol. 2003, 3: 21-10.1186/1471-2288-3-21.CrossRef
21.
go back to reference Zou G: A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004, 159: 702-706. 10.1093/aje/kwh090.CrossRef Zou G: A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004, 159: 702-706. 10.1093/aje/kwh090.CrossRef
22.
go back to reference Hosmer DW, Lemeshow S: Applied Logistic Regression. 1989, New York: WILEY, 1 Hosmer DW, Lemeshow S: Applied Logistic Regression. 1989, New York: WILEY, 1
23.
go back to reference Armitage P, Berry G, Matthews JNS: Statistical Methods in Medical Research. 2005, Oxford: Blackwell Science, Fourth Armitage P, Berry G, Matthews JNS: Statistical Methods in Medical Research. 2005, Oxford: Blackwell Science, Fourth
24.
go back to reference Donner A, Klar N: Design and Analysis of Cluster Randomisation Trials in Health Research. 2000, London: Hodder Arnold Donner A, Klar N: Design and Analysis of Cluster Randomisation Trials in Health Research. 2000, London: Hodder Arnold
25.
go back to reference Stata Statistical Software: Release 8.0. 2003, College Station, TX: Stata Corporation Stata Statistical Software: Release 8.0. 2003, College Station, TX: Stata Corporation
26.
go back to reference Stata Statistical Software: Release 9.0. 2005, College Station, TX: StataCorp LP Stata Statistical Software: Release 9.0. 2005, College Station, TX: StataCorp LP
28.
go back to reference Cleary PD, McNeil BJ: Patient satisfaction as an indicator of quality care. Inq. 1988, 25: 25-36. Cleary PD, McNeil BJ: Patient satisfaction as an indicator of quality care. Inq. 1988, 25: 25-36.
29.
go back to reference Sitzia J, Wood N: Patient satisfaction: a review of issues and concepts. Soc Sci Med. 1997, 45: 1829-1843. 10.1016/S0277-9536(97)00128-7.CrossRef Sitzia J, Wood N: Patient satisfaction: a review of issues and concepts. Soc Sci Med. 1997, 45: 1829-1843. 10.1016/S0277-9536(97)00128-7.CrossRef
30.
go back to reference Campbell SM, Hann M, Hacker J, Burns C, Oliver D, Thapar A, Mead N, Safran DG, Roland MO: Identifying predictors of high quality care in English general practice: observational study. BMJ. 2001, 323: 784-787. 10.1136/bmj.323.7316.784.CrossRef Campbell SM, Hann M, Hacker J, Burns C, Oliver D, Thapar A, Mead N, Safran DG, Roland MO: Identifying predictors of high quality care in English general practice: observational study. BMJ. 2001, 323: 784-787. 10.1136/bmj.323.7316.784.CrossRef
31.
go back to reference Baker R: General practice in Gloucestershire, Avon and Somerset: explaining variations in standards. Br J Gen Pract. 1992, 42: 415-418.PubMedPubMedCentral Baker R: General practice in Gloucestershire, Avon and Somerset: explaining variations in standards. Br J Gen Pract. 1992, 42: 415-418.PubMedPubMedCentral
Metadata
Title
Doctor and practice characteristics associated with differences in patient evaluations of general practice
Authors
Hanne N Heje
Peter Vedsted
Ineta Sokolowski
Frede Olesen
Publication date
01-12-2007
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2007
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-7-46

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