The association between the workload of general practitioners and patient experiences with care: results of a cross-sectional study in 33 countries

Abstract

Background The workload of general practitioners (GPs) and dissatisfaction with work have been increasing in various Western countries over the past decades. In this study, we evaluate the relation between the workload of GPs and patients’ experiences with care. Methods We collected data through a cross-sectional survey among 7031 GPs and 67,873 patients in 33 countries. Dependent variables are the patient experiences on doctor-patient communication, accessibility, continuity, and comprehensiveness of care. Independent variables concern the workload measured as the GP-reported work hours per week, average consultation times, job satisfaction (an indicator of subjective workload), and the difference between the workload measures of every GP and the average in their own country. Finally, we evaluated interaction effects between workload measures and what patients find important in a country and the presence of a patient-list system. Relationships were determined through multilevel regression models. Results Patients of GPs who are happier with their work were found to experience better communication, continuity, access, and comprehensiveness. When GPs are more satisfied compared to others in their country, patients also experience better quality. When GPs work more hours per week, patients also experience better quality of care, but not in the area of accessibility. A longer consultation time, also when compared to the national average, is only related to more comprehensive care. There are no differences in the relationships between countries with and without a patient list system and in countries where patients find the different quality aspects more important. Conclusions Patients experience better care when their GP has more work hours, longer consultation times, and especially, a higher job satisfaction.

Workload and job satisfaction of rural doctors during the new healthcare reform in China: a cross-sectional mixed methods study

“…In summary, our ndings are in line with previous studies, which all highlight the importance of workload on job satisfaction (31,45,46) . In addition, we further analyze the impact of three dimensions of workload on job satisfaction, and discussed the difference of this impact between urban and rural areas.…”

Mature Adults at the GP: Length of Visit and Patient Satisfaction—Associations with Patient, Doctor, and Facility Characteristics

“…Patient satisfaction (PS) among adults in primary care increases with age and, on average, reflects positive experiences [1,2]. Factors determining PS are identified as representing three main domains related to the facility [3][4][5], doctor (including the patient-doctor relationship) [5][6][7], and patient [4,8]. Established correlates of satisfaction are represented, for example, by lower staff turnover [3,4] or facility size [9]; the GP's gender, workload, and work satisfaction [2,6]; or the patient's age, health status, or the continuity of the GP's care [1,8].…”

“…Thus, exploration of this context could provide important organizational information for primary care. In turn, the CT indicates the quality of care associated with health outcomes; hence its association with PS is worth considering [6,10,11]. However, here too, characteristics of a patient (e.g., multimorbidity, deprivation status [12,13]), doctor (e.g., gender, workload, and experience [11,12]), or facility often explain the CT better than the nature of the medical problem a patient presents with [8,14].…”

“…At the same time, reports remain ambiguous regarding the relationship between the CT at the GP and patients' age [12,13,15], or between PS and their self-rated health (SRH) [13,14], yet only a handful of studies cover a wider range of CT and/or PS predictors [10,12]. Studies examining associations between the CT and PS also report discrepant findings-from none to strong [6,10,11,[15][16][17][18]. Moreover, we thought that studies illustrating the above relationships are particularly important, yet they are scarce when it comes to more mature primary care users.…”

Workload Indicators of Staffing Need (WISN) Method for Midwives Planning and Estimation at Asrade Zewude Memorial Primary Hospital, North west Ethiopia

“…This implies each health facility has its own staffing requirement depending on its workload. Following its development by WHO, the WISN has been used to determine staffing requirements in Papua New Guinea, the United Republic of Tanzania, Kenya, Sri Lanka and also in six other countries: Bahrain, Egypt, Hong Kong, Oman, Sudan and Turkey among others [4,7,[12][13][14][15][16][17][18][19][20][21].…”