Exploring differences between public and private providers in primary care: findings from a large Swedish region

Glenngård, Anna

doi:10.1017/s1744133122000251

Cited by 1 publication

(1 citation statement)

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“…Similar to findings from several other studies, a larger size of the PCP is associated with lower patient-rated performance [ 24 , 28 – 30 ]. Private PCPs correlates with higher patient-reported overall performance, which also confirms results from previous Swedish studies [ 31 ]. Not surprisingly, a higher patient-reported performance was strongly linked to PCP characteristics in terms of a better GP staffing situation.…”

Section: Discussionsupporting

confidence: 90%

Better with GPs as managers? – Variation in perceptions of feedback messages, goal-clarity and performance across manager´s in Swedish primary care

Anell

Glenngård

2023

BMC Health Serv Res

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Background Primary care in several countries is developing towards team-based and multi-professional care, requiring leadership and management capabilities at the primary care practice level. This article reports findings from a study of primary care managers in Sweden, focusing variation in performance and perceptions of feedback messages and goal-clarity, depending on managers’ professional background. Methods The study was designed as a cross-sectional analysis of primary care practice managers’ perceptions combined with registered data on patient-reported performance. Managers perceptions was collected through a survey to all 1 327 primary care practice managers in Sweden. Data about patient-reported performance was collected from the 2021 National Patient Survey in primary care. We used bivariate (Pearson correlation) and multivariate (ordinary least square regression analysis) statistical methods to describe and analyse the possible association between managers’ background, responses to survey statements and patient-reported performance. Results Both GP and non-GP managers had positive perceptions of the quality and support of feedback messages from professional committees focusing medical quality indicators, although managers perceived that the feedback facilitated improvement work to a lower degree. Feedback from the regions as payers scored consistently lower in all dimensions, especially among GP-managers. Results from regression analysis indicate that GP-managers correlate with better patient-reported performance when controlling for selected primary care practice and managerial characteristics. A significant positive relationship with patient-reported performance was also found for female managers, a smaller size of the primary care practice and a good staffing situation of GPs. Conclusions Both GP and non-GP managers rated the quality and support of feedback messages from professional committees higher than feedback from regions as payers. Differences in perceptions were especially striking among GP-managers. Patient-reported performance was significantly better in primary care practices managed by GPs and female managers. Variables reflecting structural and organizational, rather than managerial, characteristics contributed with additional explanations behind the variation in patient-reported performance across primary care practices. As we cannot exclude reversed causality, the findings may reflect that GPs are more likely to accept being a manager of a primary care practice with favourable characteristics.

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Section: Discussionsupporting

confidence: 90%