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BMC Primary Care
Published in: BMC Primary Care 1/2018

Open Access 01-12-2018 | Research article

Factors associated with low patient satisfaction in out-of-hours primary care in Denmark - a population-based cross-sectional study

Authors: Mette Tranberg, Peter Vedsted, Bodil Hammer Bech, Morten Bondo Christensen, Søren Birkeland, Grete Moth

Published in: BMC Primary Care | Issue 1/2018

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Abstract

Background

Low patient satisfaction with the quality of out-of-hours primary care (OOH-PC) has been linked with several individual and organizational factors. However, findings have been ambiguous and may not apply to the Danish out-of-hours (OOH) setting in which general practitioners (GPs) perform the initial telephone triage. This study aimed to identify patient-related, GP-related and organizational factors associated with low patient satisfaction.

Methods

The study was based on data from a 1-year population-based survey of OOH-PC (LV-KOS) in the Central Denmark Region in 2010–2011. GPs on OOH duty completed an electronic questionnaire in the OOH computer system, and the registered patients received a subsequent postal questionnaire focusing on contact evaluation, waiting time, demographic characteristics and general self-perceived health. Associations were analysed using multivariable logistic regression with dissatisfaction as the dependent variable.

Results

The patient response rate was 50.6%. For all contact types, 82.5% of the patients were satisfied with the OOH-PC service. More patients were dissatisfied with telephone consultations than with clinic consultations or home visits (8.5% vs. 6.0% and 4.3%, respectively). Contacts assessed by the GP as ‘not severe’ were associated with dissatisfaction for telephone consultations and home visits. Poor general self-perceived health was associated with dissatisfaction for all contact types. Living in urban areas was associated with dissatisfaction for telephone consultations, while unacceptable waiting time was associated with dissatisfaction for all contact types.

Conclusions

We found a high level of patient satisfaction with the OOH-PC service. The only factors affecting patient satisfaction across all contact types were unacceptable waiting time and poor general self-perceived health. For the other investigated factors, patient satisfaction depended on the type of contact. Generally, patients contacting for GP-assessed non-severe health problem and patients living in urban areas were more dissatisfied.
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Literature
1.
Danish Health and Medicines Authority. Kvaliteten i den danske lægevagtsordning [Quality of the Danish out-of-hours primary care service]. First ed.: Danish Health and Medicines Authority; 2009.
2.
Pedersen KM, Andersen JS, Søndergaard J. General practice and primary health care in Denmark. The Journal of the American Board of Family Medicine. 2012;25(Suppl 1):S34–8.CrossRefPubMed
3.
Flarup L, Moth G, Christensen MB, Vedsted P, Olesen F. Den danske lægevagtsordning i internationalt perspektiv- en sammenlignende undersøgelse af lægevagten i Danmark, England, Holland, Norge og Sverige [The Danish out-of-hours primary care service in an international perspective - a comparative study of out-of-hours primary care service in Denmark, England, Netherlands, Norway and Sweden]. First ed.: The Research Unit for General Practice, Aarhus University; 2010.
4.
Moth, G., Flarup L, Christensen B.M, Olsen F., Vedsted P. Forskningsenheden for almen praksis. Kontakt- og sygdomsmønsteret i lægevagten, LV-KOS 2011 [A survey on reasons for encounter and disease patterns in the Danish out-of hours primary care service, LV-KOS]. First ed.: The Research Unit for General Practice, Aarhus University; 2012.
5.
Mainz J, Bartels P, Bek T, Møller Pedersen K, Krøll V, Rhode P editors. Kvalitetsudvikling i praksis[Quality improvement in practice]. First ed. Copenhagen.: Munksgaard Danmark; 2011.
6.
Heje,H.N., Olsen F, Vedsted P. Patienternes vurdering af de praktiserende læger-overordnede resultater fra DanPEP-projektet [patient evaluations of general practitioners- results from the DanPEP- study]. Ugeskr Laeger 2010;172(15):1105–1112.
7.
McKinley RK, Stevenson K, Adams S, Manku-Scott TK. Meeting patient expectations of care: the major determinant of satisfaction with out-of-hours primary medical care? Fam Pract. 2002;19(4):333–8.CrossRefPubMed
8.
Shipman C, Payne F, Hooper R, Dale J. Patient satisfaction with out-of-hours services how do GP co-operatives compare with deputizing and practice-based arrangements? J Public Health Med 2000 /;22(2):149–154.
9.
Salisbury C. Postal survey of patients' satisfaction with a general practice out of hours cooperative. BMJ 1997:31;314(7094):1594–1598.
10.
McKinley RK, Roberts C. Patient satisfaction with out of hours primary medical care. Qual Health Care 2001 03;10(1):23–28.
11.
van Uden CJ, Ament AJ, Hobma SO, Zwietering PJ, Crebolder HF. Patient satisfaction with out-of-hours primary care in the Netherlands. BMC Health Serv Res. 2005 Jan 15;5(1):6.CrossRefPubMedPubMedCentral
12.
Moll van Charante E, Giesen P, Mokkink H, Oort F, Grol R, Klazinga N, et al. Patient satisfaction with large-scale out-of-hours primary health care in The Netherlands: development of a postal questionnaire. Fam Pract. 2006;23(4):437–43.CrossRefPubMed
13.
Hansen BL, Munck A. Out-of-hours service in Denmark: the effect of a structural change. Br J Gen Pract. 1998;48(433):1497.PubMedPubMedCentral
14.
Christensen M, Skafte-Holm P, Nielsen E, Greibe J, Moos A, Andersen D, et al. Hvad er din mening om lægevagten? [what is your opinion about the out-of-hours primary care service?]. Ugeskr Laeger. 2000;162:3508–12.
15.
Leibowitz R, Day S, Dunt DA. Systematic review of the effect of different models of after-hours primary medical care services on clinical outcome, medical workload, and patient and GP satisfaction. Fam Pract. 2003;20(3):311–7.CrossRefPubMed
16.
Christensen MB, Thomsen L, Oestergaard J, Skafte-Holm P. Fokus på lægevagten[ focus on the out-of-hours primary care service]. Ugeskr Laeger. 1999;161:1812–6.
17.
Glynn L, Byrne M, Newell J, Murphy A. The effect of health status on patients' satisfaction with out-of-hours care provided by a family doctor co-operative. Fam Pract. 2004;21(6):677–83.CrossRefPubMed
18.
Wilson P, McConnachie A, O'Donnell CA, Ross S, Moffat KJ, Drummond N. Assessing dissatisfaction with an out of hours service: reasons and remedies. Health Bull (Edinb). 2001 Jan;59(1):37–44.
19.
Danielsen K, Bjertnaes O, Garratt A, Forland O, Iversen H, Hunskaar S. The association between demographic factors, user reported experiences and user satisfaction: results from three casualty clinics in Norway. BMC Fam Pract. 2010;11(1):73.CrossRefPubMedPubMedCentral
20.
Baker R. Characteristics of practices, general practitioners and patients related to levels of patients' satisfaction with consultations. Br J Gen Pract. 1996;46(411):601–5.PubMedPubMedCentral
21.
Heje HN, Vedsted P, Sokolowski I, Olesen F. Doctor and practice characteristics associated with differences in patient evaluations of general practice. BMC Health Serv Res. 2007;7(1):46.CrossRefPubMedPubMedCentral
22.
Flarup L, Moth G, Christensen MB, Vestergaard M, Olesen F, Vedsted P. A feasible method to study the Danish out-of-hours primary care service. Dan Med J. 2014;61(5):A4847.PubMed
23.
Riddle DL, Lee KT, Stratford PW. Use of SF-36 and SF-12 health status measures: a quantitative comparison for groups versus individual patients. Med Care. 2001;39(8):867–78.CrossRefPubMed
24.
Holmgren K, Dahlin-Ivanoff S, Björkelund C, Hensing G. The prevalence of work-related stress, and its association with self-perceived health and sick-leave, in a population of employed Swedish women. BMC Public Health. 2009;9(1):1.CrossRef
25.
Hjollund NH, Larsen FB, Andersen JH. Register-based follow-up of social benefits and other transfer payments: accuracy and degree of completeness in a Danish interdepartmental administrative database compared with a population-based survey. Scand J Public Health. 2007;35(5):497–502.CrossRefPubMed
26.
Donner A, Klar N. Design and analysis of cluster randomization trials in Health Research: London Arnold Publishers; 2000.
27.
Millar MM, Dillman DA. Improving response to web and mixed-mode surveys. Public Opin Q. 2011;75(2):249–69.CrossRef
28.
Murphy CA. Increasing the response rates of reluctant professionals to mail surveys. Appl Nurs Res. 1993;6(3):137–41.CrossRefPubMed
29.
Crow R, Gage H, Hampson S, Hart J, Kimber A, Storey L, et al. The measurement of satisfaction with healthcare: implications for practice from a systematic review of the literature. Health Technol Assess. 2002;6(32)
30.
Vedsted P, Mainz J, Olsen F. Betydning af påmindelser og lægens engagement ved en spørgeskemaundersøgelse i almen praksis [the significance of reminders and the engagement of GPs in a questionnaire survey in general practice]. Ugeskr Laeger. 2001;163(40):5529–32.PubMed
31.
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(1):21.CrossRefPubMedPubMedCentral
32.
Hall JA, Milburn MA, Epstein AMA. Causal model of health status and satisfaction with medical care. Med Care. 1993:84–94.
Metadata
Title
Factors associated with low patient satisfaction in out-of-hours primary care in Denmark - a population-based cross-sectional study
Authors
Mette Tranberg
Peter Vedsted
Bodil Hammer Bech
Morten Bondo Christensen
Søren Birkeland
Grete Moth
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2018
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-017-0681-6

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