The effect of the general practitioner as the first point of contact for care on the satisfaction with health care services in persons living with chronic spinal cord injury: A cross-sectional study

OBJECTIVE

The primary objective of this study was to investigate the effect of having a general practitioner (GP) as a first point of contact for care on the satisfaction with care services in persons with spinal cord injury (SCI), and how this effect is related to socio-demographic and health-related factors.

METHODS

This is a cross-sectional survey conducted within the framework of the Swiss Spinal Cord Injury Cohort Study Community Survey 2017. Outcome measures comprised three aspects of care (treatment with respect, understandability of explanations, and involvement in decision-making) and satisfaction with GP care and SCI centres. Information was grouped by first contact of care (GP or SCI specialist) and compared using the Mann-Whitney U test and logistic regression analysis.

RESULTS

Out of 3,959 invitees, 1,294 participants (33%) completed the survey. No significant association was found between the three aspects of care and the first contact of care. Persons who first contacted a GP and lived within a 10-minute travel distance to the GP practice were significantly less likely to be satisfied with their GP care (-5.7 percentage points, CI 95% = -10.7, -0.7), as compared to those living farther away. Persons who first contacted a GP rather than an SCI specialist were more likely to be satisfied with their GP care if married (7.1 percentage points, CI 95% = 1.4, 12.7), employed (6.6 percentage points, CI 95% = 0.9, 12.3), had a high social status (11.0 percentage points, CI 95% = 2.0, 20.1), or had tetraplegia (10.8 percentage points, CI 95% = 3.6, 18.1). For the same group, satisfaction with SCI centres was significantly higher in persons with good (10.1 percentage points, CI 95% = 0.1, 20.1) or very good health (8.2 percentage points, CI 95% = 1.0, 15.4), as compared to those with poor health.

CONCLUSION

The majority of participants were satisfied with the services offered by their first contact point for care, with variations due to factors endogenous to the participants. Socio-demographic and health-related factors should be integrated into health care planning strategies and improvement initiatives to ensure equitable access and better quality of health care services.

General and Vulnerable Population’s Satisfaction With the Healthcare System in Urban and Rural Areas: Findings From the European Social Survey

Introduction: Access to the healthcare system when patients are vulnerable and living outside metropolitan areas can be challenging. Our objective was to explore healthcare system satisfaction of urban and rural inhabitants depending on financial and health vulnerabilities.

Methods: Repeated cross-sectional data from 353,523 European citizens (2002–2016). Multivariable associations between rural areas, vulnerability factors and satisfaction with the healthcare system were assessed with linear mixed regressions and adjusted with sociodemographic and control factors.

Results: In unadjusted analysis, the people who lived in houses in the countryside and those who lived in the suburbs were the most satisfied with the healthcare system. In the adjusted model, residents living in big cities had the highest satisfaction. Financial and health vulnerabilities were associated with less satisfaction with the healthcare system, with a different effect according to the area of residence: the presence of health vulnerability was more negatively correlated with the healthcare system satisfaction of big city inhabitants, whereas financial vulnerability was more negatively correlated with the satisfaction of those living in countryside homes.

Conclusion: Vulnerable residents, depending on their area of residence, may require special attention to increase their satisfaction with the healthcare system.

Can you recommend me a good GP? Describing social differences in patient satisfaction within 31 countries

Objective

This study aims to explore social differences in patient satisfaction of their general practitioner (GP) according to patient's gender, education, household income and ethnicity in Europe.

Design

By using multilevel logistic modelling the impact of socioeconomic indicators (i.e. gender, education, household income and ethnicity) on patient satisfaction is estimated. In each model the authors controlled for indicators of person-focused care and strength of the primary care system.

Setting

Primary care in 31 European countries.

Participants

Patients who were sitting in the waiting room of the GP were asked to participate. They filled in the questionnaire after the consultation with the GP.

Intervention

Describing social differences in patient satisfaction among European primary care patients.

Main Outcome Measure(s)

Patient satisfaction.

Results

This study confirms previous research and reveals high levels of satisfaction with primary care in Europe. On average, 92.1% of the respondents would recommend their GP to their family or relatives. Variance in patient satisfaction is mostly explained at patient level, ~75% of the variance can be assigned to patient characteristics. Likewise, women, low-income groups and first generation migrants are less satisfied with their GP. Lastly, all indicators of person-focused care are positively associated with patient satisfaction, showing that the more person-focused the care, the higher the satisfaction among the patients.

Conclusions

Notwithstanding the high satisfaction rates in Europe, patient satisfaction is still determined by patients' socioeconomic status (gender and household income), migration background and the degree of person-centred care. Therefore, policymakers and health professionals should target these population groups in order to improve the satisfaction rates in their country.

Consumer satisfaction with tertiary healthcare in China: findings from the 2015 China National Patient Survey

Objective

This study aims to develop understanding of Chinese patient satisfaction with tertiary hospitals.

Design

The study draws on data collected from the 2015 China National Patient Survey. A Likert five-point scale was used to formulate the questionnaires. Descriptive analysis and logistic regression analysis were conducted.

Setting

A structured questionnaire was used by 1432 interviewers to interview 27 475 outpatients and 19 938 inpatients in 136 tertiary hospitals from 31 provinces.

Participants

Outpatients in the dispensing area and inpatients in the discharging area were randomly interviewed.

Main Outcome Measure(s)

Key domains of the questionnaire include the layout of service functions, environment maintenance, process management, quality of care, humane care and the patient-doctor relationship. Within each domain, several indicators were set, and each indicator was given a statement.

Results

The overall satisfaction scores are 4.42 ± 0.68 and 4.67 ± 0.62 for outpatient and inpatient, respectively. The domains with highest satisfaction are 'diagnosis and treatment' for outpatient and 'nursing care' for inpatient. Outpatients were least satisfied with long waiting time, while inpatients were least satisfied with the food. The strongest predictor of overall satisfaction appears to be 'patient-doctor relationship' for both outpatients (OR = 3.53, 95% CI: 3.17-3.92) and inpatients (OR = 7.34, 95% CI: 5.55-9.70).

Conclusions

Chinese hospitals need to pay more attention to offering more humane care to patients, hospital environment and process management improvement, reducing waiting times for seeing doctors and outpatient testing, and improving amenity services such as better food in the wards.