Programme no. 221-OP
Are patient experiences in general practice affected by independent organizational factors?
Torunn Bjerve Eide*1, Jørund Straand2, Hasse Melbye3, Elin Olaug Rosvold4
1Department of General Practice,Institute for Health and Society, University of Oslo,Oslo,Norway, 2Department of General Practice,Institute for Health and Society, University of Oslo,Oslo,Norway, 3General Practice Research Unit,University of Tromsø,Tromsø,Norway, 4Department of General Practice,Institute for Health and Society, University of Oslo,Oslo,Norway
* = Presenting author
Objectives: The aim of this study is to assess the impact of independent characteristics of GPs and their practices on the patient´s experience of communication with the doctors. Our hypothesis is that the patient`s experience may be influenced by the size of the GP's patient list, the geographical location of the GP`s practice, the duration of the consultation, whether the doctor is self-employed or on regular salaries and the doctor`s sex and age
A consultation between a general practitioner (GP) and a patient is to a certain extent a predetermined situation with a given framework. However, there are considerable differences as to how GPs organize their practices. Scarce literature exists concerning the impact of these external factors on patients´ experience of a visit to the GP.
In Norway, the coordination reform for the health services was launched in 2012. This also entails a discussion about how general practice should be organized to ensure high quality services to all inhabitants. More knowledge of the consequences of organisational differences is needed to provide a basis for good decisions.
Results: The patients indicated overall positive experiences with their visits. Patients who attended doctors with both short and long patient lists had more negative experiences compared to those who attended doctors with medium sized lists. The experience was affected by the geographical location of the practice, but it was not affected by the duration of the consult, the doctor´s sex or age, whether the GP was the patient´s regular doctor or whether the doctor was self-employed or not.
This study is based on the data from the Norwegian branch of the international multi-center study Quality and Costs of Primary Care in Europe. The Norwegian material includes 198 doctors and 1707 patients, who answered questionnaires concerning practice organization, patient experiences and patient values. We identified seven dependent variables that provide information on how the patients perceived their visit at the doctor´s office and the communication with the doctor. We used multilevel analysis to identify significant associations between independent characteristics of the GPs and the experience of the patients.
Conclusion: The patient experience is to a certain extent affected by external factors characterizing the GP and his or her practice. This will be presented in more detail at the conference.
Points for discussion: Should we aim for a standardized organization of general practice? Could it be a good thing that variation exists?