Drivers of overall satisfaction with primary care: evidence from the English General Practice Patient Survey
Drivers of overall satisfaction with primary care: evidence from the English General Practice Patient Survey
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DOI：
10.1111/hex.12081
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发表时间：
2015-10-01
影响因子：
3.2
通讯作者：
Campbell, John L.
中科院分区：
文献类型：
--
作者：
Paddison, Charlotte A. M.;Abel, Gary A.;Campbell, John L.
背景/目的为了确定初级保健的哪些方面对患者最重要，我们的目标是确定患者体验中与总体满意度关系最密切的方面，并检查这些关系因社会人口统计学和健康特征而异的程度。10英国全科医疗患者调查，包括2169718名受访者，注册了8362个初级保健实践。测量/分析线性混合效应回归模型（固定效应调整年龄，性别，种族，剥夺，自我报告的健康状况，自我报告的心理健康状况和随机实践效应）从涵盖四个护理领域的六个项目预测总体满意度：接待员的服务态度、医生沟通和护士沟通。结果医生沟通与总体满意度的关系最强（标准化系数0.48，95%CI = 0.48，0.48），其次是接待人员的乐于助人（标准化系数0.22，95%CI = 0.22，0.22）。在患者体验的六项指标中，提前预约与总体满意度的关系最弱（标准化系数0.06，95%CI = 0.05，0.06）。互动表现出统计上的显着差异，但在不同的患者groups.Conclusions司机的重要性，与医生的沟通是最重要的驱动程序的整体满意度与初级保健在英格兰，沿着与乐于助人的接待员。相比之下，尽管获得机会的措施，包括获得任命的能力，是政府的一个政策优先事项，但与总体满意度的关系不大。
Background/objectives To determine which aspects of primary care matter most to patients, we aim to identify those aspects of patient experience that show the strongest relationship with overall satisfaction and examine the extent to which these relationships vary by socio-demographic and health characteristics.Design/setting Data from the 2009/10 English General Practice Patient Survey including 2 169 718 respondents registered with 8362 primary care practices.Measures/analyses Linear mixed-effects regression models (fixed effects adjusting for age, gender, ethnicity, deprivation, self-reported health, self-reported mental health condition and random practice effect) predicting overall satisfaction from six items covering four domains of care: access, helpfulness of receptionists, doctor communication and nurse communication. Additional models using interactions tested whether associations between patient experience and satisfaction varied by socio-demographic group.Results Doctor communication showed the strongest relationship with overall satisfaction (standardized coefficient 0.48, 95% CI = 0.48, 0.48), followed by the helpfulness of reception staff (standardized coefficient 0.22, 95% CI = 0.22, 0.22). Among six measures of patient experience, obtaining appointments in advance showed the weakest relationship with overall satisfaction (standardized coefficient 0.06, 95% CI = 0.05, 0.06). Interactions showed statistically significant but small variation in the importance of drivers across different patient groups.Conclusions For all patient groups, communication with the doctor is the most important driver of overall satisfaction with primary care in England, along with the helpfulness of receptionists. In contrast, and despite being a policy priority for government, measures of access, including the ability to obtain appointments, were poorly related to overall satisfaction.