Grol R, Wensing M, Mainz J, Jung H P, Ferreira P, Hearnshaw H, Hjortdahl P, Olesen F, Reis S, Ribacke M, Szecsenyi J
University of Nijmegen, The Netherlands.
Br J Gen Pract. 2000 Nov;50(460):882-7.
Patients' evaluations can be used to improve health care and compare general practice in different health systems.
To identify aspects of general practice that are generally evaluated positively by patients and to compare opinions of patients in different European countries on actual care provision.
An internationally-validated questionnaire was distributed to and completed by patients in 10 European countries. A stratified sample of 36 practices per country, with at least 1080 patients per country, was included. A set of 23 validated questions on evaluations of different aspects of care was used, as well as questions on age, sex, overall health status, and frequency of visiting the GP.
The patient sample included 17,391 patients in 10 different countries; the average response rate was 79% (range = 67% to 89%). In general, patients visiting their general practitioner (GP) were very positive about the care provided. For most of the 23 selected aspects of care more than 80% viewed care as good or excellent; in particular, keeping records confidential, GP listening to patients, time during consultations, and quick services in case of urgent problems were evaluated positively. Patients were relatively negative about organisational aspects of care. The evaluations in different countries were largely similar, with some interesting differences; for instance, service and organisational aspects were evaluated more positively in fee-for-service health systems.
Patients in Europe are positive about general practice but improvements in practice management in some countries are requested. More research is needed to study the complex field of differences in expectations and evaluations between countries with different health systems.
患者评价可用于改善医疗保健并比较不同卫生系统中的全科医疗。
确定患者普遍给予积极评价的全科医疗方面，并比较不同欧洲国家患者对实际医疗服务提供的看法。
向10个欧洲国家的患者发放并由其完成一份经过国际验证的问卷。每个国家纳入36个医疗机构的分层样本，每个国家至少有1080名患者。使用了一组关于医疗不同方面评价的23个经过验证的问题，以及关于年龄、性别、总体健康状况和看全科医生频率的问题。
患者样本包括来自10个不同国家的17391名患者；平均回复率为79%（范围 = 67%至89%）。总体而言，看全科医生的患者对所提供的医疗服务非常满意。在所选的23个医疗方面中，大多数方面超过80%的患者认为医疗服务良好或优秀；特别是，保密记录、全科医生倾听患者意见、会诊时间以及紧急情况下的快速服务得到了积极评价。患者对医疗的组织方面评价相对较低。不同国家的评价在很大程度上相似，但也存在一些有趣的差异；例如，在按服务收费的卫生系统中，对服务和组织方面的评价更为积极。
欧洲患者对全科医疗持积极态度，但一些国家要求改善医疗管理。需要更多研究来探讨不同卫生系统国家之间期望和评价差异的复杂领域。
