Patients´ Values in Nordic General Practice; A Report From the QUALICOPC Study
Torunn Bjerve Eide, Jørund Straand, Anja Maria Brænd
Background. Patients' expectations and preferences are important for improving the quality of care. We have explored Nordic patients´ views of the importance of different aspects of quality in general practice. Methods. In the Nordic countries, patients were recruited in general practitioners' (GPs´) waiting rooms and asked to fill in a questionnaire ranking the importance of 47 statements reflecting five domains concerning quality of care in general practice: communication, involvement,
... bility, continuity, and comprehensiveness. Questionnaire items rated as important or very important by ≥ 90% of participants in all countries were considered to be universally of high importance. Logistic regression was used to identify associations between assessments and patient characteristics.Results. 707 patients responded, ranging from 82 (Iceland) to 209 (Denmark) per country. 90 % or more of patients in each country rated ten statements as important or very important: six pertained to communication with the GP, three to patient involvement and one to comprehensiveness of care. No items regarding accessibility or continuity of care exceeded the 90% limit in all countries. The item most frequently rated as very important was "I understand what the GP explains". Female patients were more likely than males (OR=2.9; 95%CI 1.5-5.5) to value that a GP treats them as a person rather than just a medical problem, and also that they receive instructions regarding what to do if things went wrong (1.7; 1.2-2.2). Older patients >65 years put less emphasis than those aged <35 on whether the GP takes them seriously (0.4; 0.3-0.5), and also on the importance of receiving instructions for what to do if something went wrong (0.5; 0.4-0.7). Patients with chronic disease were less concerned (0.6; 0.4-0.8), with receiving instructions, but valued strongly that a GP knows when to refer them (2.2; 1.5-3.3). Conclusion. Patients in all countries assigned high value to the communication with their GP. Availability was also deemed important by patients, but came secondary to good communication quality. The organisational framework for general practice organisation must allow for acceptable quality of communication as well as availability.