Assessing the potential for improvement of primary care in 34 countries: a cross-sectional survey

Schäfer, Willemijn; Boerma, W.G.W.; Murante, Anna Maria; Sixma, H.; Schellevis, François G.; Groenewegen, Peter

doi:10.2471/blt.14.140368

Cited by 58 publications

(71 citation statements)

References 16 publications

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“…It was found that in most of the countries, primary care shows one or more features with a medium or high level of patient-perceived improvement potential. In Poland, “Comprehensiveness” was indicated as a priority area with a medium level of patient-perceived improvement potential [29]. Nevertheless, in comparison to the doctors, Polish patients have explicitly more positive opinions about the quality of primary care.…”

Section: Discussionmentioning

confidence: 99%

Quality of primary health care in Poland from the perspective of the physicians providing it

et al. 2016

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BackgroundPrimary care (PC) allows patients to address most of their health needs and is essential for high quality healthcare systems. The aim of the study was to analyze the insight of nine core dimensions of Polish PC system: “Economic conditions”, “Workforce”, “Accessibility”, “Comprehensiveness”, “Continuity”, “Coordination”, “Quality of care”, “Efficiency” and “Equity” and to identify the characteristics of the providing physicians that influence their perception of the quality of care.MethodsA cross-sectional study was conducted as part of an international QUALICOPC project. In Poland a nationally representative sample of 220 PC physicians was selected from the database of Polish National Health Fund by a stratified random sampling procedure. The research tool was a standardized 64-item questionnaire. Each of the respondents’ answers were assigned a numerical value ranging from−1 (extremely negative) to +1 (extremely positive). The quality indicators were calculated as an arithmetic mean of variables representing particular PC dimensions.ResultsThe mean scores for the majority of the dimensions had negative values. Accessibility of care was perceived as the best dimension, while the economic conditions were evaluated most negatively. Only a small part of variation in quality evaluation could be explained by physicians’ characteristics.ConclusionsThe negative evaluation of primary care reflects the growing crisis in the health care system in Poland. There is an urgent need to apply complex recovery measures to improve the quality of primary care.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-016-0550-8) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Quality of primary health care in Poland from the perspective of the physicians providing it

et al. 2016

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“…The PHC system in Greece has reported low performance in several areas of quality-based care [4, 16]. A recently published paper of Schäfer et al reported on data from the Quality and Costs of Primary Care in Europe (QUALICOPC), which examined quality indicators as perceived by patients in 34 countries including Greece [17]. Five dimensions of person-focused primary care have been assessed by the QUALICOPC project: accessibility, continuity and coordination, comprehensiveness, patient activation, and doctor–patient communication [1, 18].…”

Section: Introductionmentioning

confidence: 99%

Informing primary care reform in Greece: patient expectations and experiences (the QUALICOPC study)

Lionis

Papadakis

Tatsi

et al. 2017

BMC Health Serv Res

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BackgroundPrimary health care is the cornerstone of a high quality health care system. Greece has been actively attempting to reform health care services in order to improve heath outcomes and reduce health care spending. Patient-centered approaches to health care delivery have been increasingly acknowledged for their value informing quality improvement activities. This paper reports the quality of primary health care services in Greece as perceived by patients and aspects of health care delivery that are valued by patients.MethodsThis study was conducted as part of the Quality and Costs of Primary Care in Europe (QUALICOPC) study. A cross-sectional sample of patients were recruited from general practitioner’s offices in Greece and surveyed. Patients rated five features of person-focused primary care: accessibility; continuity and coordination; comprehensiveness; patient activation; and doctor–patient communication. One tenth of the patients ranked the importance of each feature on a scale of one to four, and nine tenths of patients scored their experiences of care received. Comparisons were made between patients with and without chronic disease.ResultsThe sample included 220 general practitioners from both public and private sector. A total of 1964 patients that completed the experience questionnaire and 219 patients that completed the patient values questionnaire were analyzed. Patients overall report a positive experiences with the general practice they visited. Several gaps were identified in particular in terms of wait times for appointments, general practitioner access to patient medical history, delivery of preventative services, patient involvement in decision-making. Patients with chronic disease report better experience than respondents without a chronic condition, however these patient groups report the same values in terms of qualities of the primary care system that are important to them.ConclusionsData gathered may be used to improve the quality of primary health care services in Greece through an increased focus on patient-centered approaches. Our study has identified several gaps as well as factors within the primary care health system that patient’s perceive as most important which can be used to prioritize quality improvement activities, especially within the austerity period. Study findings may also have application to other countries with similar context and infrastructure.

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“…Other factors are related to the GP profile [39–41, 43], as well as the characteristics of general practice, such as the practice size [39, 40], personal list system [39, 40] and practice type [44]. The features of the national health system also influence patient satisfaction [45–47]. …”

Section: Introductionmentioning

confidence: 99%

Is the co-location of GPs in primary care centres associated with a higher patient satisfaction? Evidence from a population survey in Italy

Bonciani

Barsanti

Murante

2017

BMC Health Serv Res

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BackgroundSeveral countries have co-located General Practitioners (GPs) in Primary Care Centres (PCCs) with other health and social care professionals in order to improve integrated care. It is not clear whether the co-location of a multidisciplinary team actually facilitates a positive patient experience concerning GP care. The aim of this study was to verify whether the co-location of GPs in PCCs is associated positively with patient satisfaction with their GP when patients have experience of a multidisciplinary team. We also investigated whether patients who frequently use health services, due to their complex needs, benefitted the most from the co-location of a multidisciplinary team.MethodsThe study used data from a population survey carried out in Tuscany (central Italy) at the beginning of 2015 to evaluate the patients’ experience and satisfaction with their GPs. Multilevel linear regression models were implemented to verify the relationship between patient satisfaction and co-location. This key explanatory variable was measured by considering both the list of GPs working in PCCs and the answers of surveyed patients who had experienced the co-location of their GP in a multidisciplinary team. We also explored the effect modification on patient satisfaction due to the use of hospitalisation, access to emergency departments and visits with specialists, by performing the multilevel modelling on two strata of patient data: frequent and non-frequent health service users.ResultsA sample of 2025 GP patients were included in the study, 757 of which were patients of GPs working in a PCC. Patient satisfaction with their GP was generally positive. Results showed that having a GP working within a PCC and the experience of the co-located multidisciplinary team were associated with a higher satisfaction (p < 0.01). For non-frequent users of health services on the other hand, the co-location of multidisciplinary team in PCCs was not significantly associated with patient satisfaction, whereas for frequent users, the strength of relationships identified in the overall model increased (p < 0.01).ConclusionThe co-location of GPs with other professionals and their joint working as experienced in PCCs seems to represent a greater benefit for patients, especially for those with complex needs who use primary care, hospitals, emergency care and specialized care frequently.

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Assessing the potential for improvement of primary care in 34 countries: a cross-sectional survey

Cited by 58 publications

References 16 publications

Quality of primary health care in Poland from the perspective of the physicians providing it

Quality of primary health care in Poland from the perspective of the physicians providing it

Informing primary care reform in Greece: patient expectations and experiences (the QUALICOPC study)

Is the co-location of GPs in primary care centres associated with a higher patient satisfaction? Evidence from a population survey in Italy

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