Shipman C, Payne F, Hooper R, Dale J
Department of General Practice and Primary Care, Guy's King's and St Thomas' School of Medicine, London.
J Public Health Med. 2000 Jun;22(2):149-54. doi: 10.1093/pubmed/22.2.149.
Although the rapid growth in general practitioner (GP) co-operatives has met with GP satisfaction, little is known about patient satisfaction. This study compares patient satisfaction with co-operative, GP practice-based and deputizing arrangements within one geographical area 15 months after a co-operative had become established; and with telephone, primary care centre and home consultations within the co-operative.
A validated postal questionnaire survey of weighted samples of patients making contact with the co-operative, practice-based and deputizing arrangements was undertaken.
A total of 1,823 (53.2 per cent) patients responded. There were no significant differences between organizations in terms of overall satisfaction, but patients using practice-based arrangements were significantly more satisfied with the waiting time for telephone consultations (p<0.001) and more satisfied with waiting times for home visits than deputizing patients (p=0.020). Within the co-operative, overall satisfaction, satisfaction with the doctor's manner and with the process of making contact was greater among those attending the primary care centre, and satisfaction with explanation and advice received greater than for patients receiving telephone consultations alone (p<0.01). Those receiving telephone advice reported increased information needs and help seeking during the following week (p< 0.05).
Overall, patients were as satisfied with the co-operative as with practice-based or deputizing service arrangements, although many concerns were expressed about the quality of service provision. Differences in satisfaction were greater between forms of service delivery within the co-operative. Dissatisfaction with telephone consultations needs to be considered, together with issues relating to equity in access to out-of-hours' primary care centre consultations and the potential impact of NHS Direct.
尽管全科医生（GP）合作社迅速发展，且全科医生对此感到满意，但患者满意度情况却鲜为人知。本研究比较了在合作社成立15个月后，同一地理区域内患者对合作社、基于全科医生诊所及代理服务安排的满意度；以及合作社内部电话咨询、初级保健中心咨询和上门咨询的满意度。
对与合作社、基于诊所及代理服务安排有接触的患者加权样本进行了一项经过验证的邮寄问卷调查。
共有1823名患者（53.2%）做出回应。各组织在总体满意度方面无显著差异，但使用基于诊所安排的患者对电话咨询等待时间的满意度显著更高（p<0.001），且对上门就诊等待时间的满意度高于代理服务患者（p=0.020）。在合作社内部，初级保健中心就诊患者的总体满意度、对医生态度及联系过程的满意度更高，对所获解释和建议的满意度高于仅接受电话咨询的患者（p<0.01）。接受电话咨询的患者表示在接下来的一周内信息需求和寻求帮助的情况有所增加（p<0.05）。
总体而言，患者对合作社的满意度与基于诊所或代理服务安排的满意度相当，尽管对服务提供质量存在诸多担忧。合作社内部不同服务形式之间的满意度差异更大。需要考虑对电话咨询的不满，以及与非工作时间初级保健中心咨询的公平获取相关问题和国民保健服务热线（NHS Direct）的潜在影响。
