Grol R, Wensing M, Mainz J, Ferreira P, Hearnshaw H, Hjortdahl P, Olesen F, Ribacke M, Spenser T, Szécsényi J
Centre for Quality of Care Research, Universities of Nijmegen/Maastricht, The Netherlands.
Fam Pract. 1999 Feb;16(1):4-11. doi: 10.1093/fampra/16.1.4.
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?
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.
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.
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.
提高全科医疗对患者需求的敏感度,需要充分了解患者在医疗服务提供方面的期望和优先事项。深入了解不同文化和医疗体系中患者期望的差异,可能有助于为全科医疗中理想的服务模式决策提供支持。开展了一项国际研究,以确定患者在全科医疗中的优先事项:不同国家的患者有哪些共同观点,哪些观点存在差异?
在英国、挪威、瑞典、丹麦、荷兰、德国、葡萄牙和以色列的全科诊所进行书面调查。每个国家至少选取12家诊所的患者样本,根据地区和诊所类型进行分层。患者对基于文献分析、定性研究和共识讨论选定的38个不同方面的全科医疗服务的重要性进行评分。比较各国之间的排名。
共有3540名患者(平均回复率55%)完成了问卷。不同国家的患者有许多共同的看法。排名最高的方面包括:会诊时有足够的时间;紧急情况下的快速服务;患者信息的保密性;告知患者他们想了解的关于其疾病的所有信息;让患者能够自由谈论他们的问题;全科医生定期参加课程;以及提供预防服务。然而,在一些选定方面,不同国家患者的意见也存在差异。患者特征的混杂效应可能在这些差异中起到了作用。
该研究提供了关于患者对全科医疗服务的期望和重视内容的信息。研究表明,不同文化和医疗体系中的患者在某些医疗方面可能有不同观点,但最重要的是,他们有许多共同观点,特别是在医患沟通和服务可及性方面。