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Family Practice Vol. 16, No. 1, 4-11
© Oxford University Press 1999

Patients' priorities with respect to general practice care: an international comparison

Richard Grol, Michel Wensing, Jan Mainza, Pedro Ferreirab, Hilary Hearnshawc, Per Hjortdahld, Frede Olesena, Mats Ribackee, Tomi Spenserf, Joachim Szécsényig and Paper prepared by the European Task Force on Patient Evaluations of General Practice(europep).

Centre for Quality of Care Research, Universities of Nijmegen/Maastricht, The Netherlands,
a Research Unit for General Practice, Aarhus University, Denmark,
b Centre for Social Studies, University Coimbra, Portugal,
c Eli Lilly National Clinical Audit, University of Leicester, UK,
d Department of General Practice, University of Oslo, Norway,
e Department of Family Medicine, University of Uppsala, Sweden,
f Department of Family Health Care, The Technion, Haifa, Israel and
g Institute on Applied Quality Improvement and Research in Health Care, Göttingen, Germany.

Background and objectives. Improving the sensitivity of general practice to Patients' needs demands a good understanding of Patients' expectations and priorities in care provision. Insight into differences in expectations of patients in different cultures and health care systems may support decision-making on desirable models for care provision in general practice. An international study was conducted to determine priorities of patients in general practice care: which views do patients in different countries have in common and which views differ?

Methods. Written surveys in general practices in the UK, Norway, Sweden, Denmark, The Netherlands, Germany, Portugal and Israel were performed. Samples of patients from at least 12 practices per country, stratified according to area and type of practice, were included. Patients rated the importance of 38 different aspects of general practice care, selected on the basis of literature analysis, qualitative studies and consensus discussions. Rankings between countries were compared.

Results. A total number of 3540 patients (response rate on average 55%) completed the questionnaire. Patients in different countries had many opinions in common. Aspects that got the highest ranking were: getting enough time during the consultation; quick services in case of emergencies; confidentiality of information on patients; telling patients all they want to know about their illness; making patients feel free to talk about their problems; GPs going to courses regularly; and offering preventive services. However, differences between opinions of patients in different countries were also found for some of the selected aspects. A confounding effect of Patients' characteristics may have played a role in these differences.

Discussion. The study provides information on what patients expect of and value in general practice care. It shows that patients in different cultures and health care systems may have different views on some aspects of care, but most of all that they have many views in common, particularly as far as doctor–patient communication and accessibility of services are concerned.

Keywords. Doctor–patient communication, general practice care, international comparison, Patients' expectations, Patients' priorities..


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