Patient satisfaction with availability of general practice:: an international comparison
Patient satisfaction with availability of general practice:: an international comparison
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DOI：
10.1093/oxfordjournals.intqhc.a002597
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发表时间：
2002-04-01
影响因子：
2.6
通讯作者：
Grol, R
中科院分区：
文献类型：
--
作者：
Wensing, M;Vedsted, P;Grol, R
Objective.确定全科医生和实践的特点之间的关联，以及患者对全科医生可用性的评价。患者完成的书面调查。设置。九个欧洲国家的全科医疗护理：丹麦、德国、荷兰、挪威、英国、比利时（弗兰德斯和瓦隆）、瑞士、斯洛文尼亚和西班牙。15996名连续访问全科医生的成年患者（每个国家的应答率在47%和89%之间变化）。Europep工具用于评估患者对全科医疗服务可用性的五个方面的评价：（1）预约，（2）接通电话，（3）能够通过电话与医生交谈，（4）在候诊室的等待时间，（5）为紧急健康问题提供快速服务。每位全科医生记录了年龄、性别、执业年限、执业医生和其他护理提供者的数量以及执业的城市化水平。患者更积极的评价与实践中更少的全科医生相关，除了为紧急健康问题提供快速服务（条件总优势比范围，1.69-2.02）。此外，还发现了一些显著的无条件总体优势比，特别是与全科医生的工作时间和实践中的护理提供者数量有关的优势比。在所有国家均未发现一致的相关性。病人喜欢小诊所和全职全科医生，这与许多国家全科医生的发展相矛盾。政策制定者应该考虑如何解决病人的观点和组织发展之间的紧张关系。
Objective. To identify associations between the characteristics of general practitioners and practices, and patients' evaluations of the availability of general practice.Design. Written surveys completed by patients.Setting. General practice care in nine European countries: Denmark, Germany, The Netherlands, Norway, UK, Belgium (Flanders and Wallonia), Switzerland, Slovenia and Spain.Study participants. 15 996 adult patients consecutively visiting the general practitioner (response rates per country varied between 47 and 89%).Main measures. The Europep instrument to assess patients' evaluations of five aspects of the availability of general practice care: (1) getting an appointment, (2) getting through on the phone, (3) being able to speak to the practitioner on the telephone, (4) waiting time in the waiting room, and (5) providing quick services for urgent health problems. Each general practitioner recorded age, sex, number of years in the practice, number of practitioners and other care providers in the practice, and urbanization level of the practice.Results. Patients' more positive evaluations were associated with fewer general practitioners in the practice, except for quick services for urgent health problems (range of conditional overall odds ratios, 1.69-2.02). In addition, a number of significant unconditional overall odds ratios were found, particularly those related to the number of general practitioners' working hours and the number of care providers in the practice. None of the associations was found consistently in all countries.Conclusion. Patients favour small practices and full-time general practitioners, which contradicts developments in general practice in many countries. Policy makers should consider how the tensions between patients' views and organizational developments can be solved.