Patient experience in primary care: association with patient, physician and practice characteristics in a fee-for-service system.

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State: Public
Version: Final published version
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_B2D6F3CF2A98
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Patient experience in primary care: association with patient, physician and practice characteristics in a fee-for-service system.
Journal
Swiss Medical Weekly
Author(s)
Cohidon C., Wild Pascal, Senn N.
ISSN
1424-3997 (Electronic)
ISSN-L
0036-7672
Publication state
Published
Issued date
2018
Peer-reviewed
Oui
Volume
148
Pages
w14601
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Nowadays we typically use patient experience as a quality of care indicator, although this has some limitations. The aim of this study was to investigate to what extent patient, physician and practice characteristics were associated with patient-reported experience of care in the major dimensions in family medicine in a fee-for-service system.
The data came from the Swiss part of the Quality and Costs of Primary Care (QUALICOPC) study, an international cross-sectional survey. A random sample of 194 Swiss family physicians and 1540 of their patients were included in this analysis. We assessed patient experience using three scores characterising access, communication and continuity-coordination. Multilevel statistical methods were used to analyse these scores based on patient-level, physician-level and practice-level factors.
Poor experience of access was associated with poor health (incidence rate ratio [IRR] 1.91, 95% confidence interval [CI] 1.54-2.55) but was lower among older patients (IRR 0.75, 95% CI 0.63-0.88). Experience of access was also reported as poorer in urban areas and in practices including other paramedical professionals (besides medical assistants) (IRR 1.27, 95% CI 1.06-1.51). Communication was reported as poorer in practices where physicians achieve greater daily face-to-face consultations (IRR 1.16, 95% CI 1.08-1.25) and in patients reporting higher incomes (IRR 1.24, 95% CI 1.01-1.52). Additionally, younger patients reported poorer continuity-coordination experience. In the continuity-coordination domain, patient experience appeared better in group practices (including other family physicians) and in those of physicians with a greater weekly workload in terms of hours. Finally, we found experience of communication and continuity better in the French-speaking area than German-speaking area of Switzerland.
In this study, we found that patient experience in family medicine in Switzerland was very good for all domains studied; access, family physician-patient communication and continuity-coordination of care. Most often, predictive factors of care experience relate to the patient's characteristics, such as age and health status. However, several practice characteristics such as size, composition and functioning (in particular, time spent with the patient) represent potential levers for improving patient-reported experience. The variations observed between the three linguistic areas in Switzerland are also interesting, since they raise the issue of the role of sociocultural factors in this field.
Keywords
Age Factors, Cross-Cultural Comparison, Cross-Sectional Studies, Europe, Fee-for-Service Plans, Female, Humans, Male, Middle Aged, Patient Satisfaction/statistics & numerical data, Physician-Patient Relations, Physicians, Family/statistics & numerical data, Practice Patterns, Physicians'/statistics & numerical data, Primary Health Care/methods, Surveys and Questionnaires, Switzerland
Pubmed
Web of science
Open Access
Yes
Create date
12/04/2018 17:45
Last modification date
20/08/2019 16:21
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