Jung H P, Wensing M, Olesen F, Grol R
Centre for Quality of Care Research, University of Nijmegen and University of Maastricht, The Netherlands.
Qual Saf Health Care. 2002 Dec;11(4):315-9. doi: 10.1136/qhc.11.4.315.
To compare patients' and general practitioners' (GPs') evaluations of the quality of general practice care.
Written surveys among patients and GPs.
General practice in the Netherlands.
1772 patients (from 45 GPs) and a random sample of 315 GPs.
Patients' and GPs' evaluations of 23 aspects of general practice care and GPs' perceptions of patients' evaluations using a 5 point scale.
The response rate was 88% in the patient sample and 63% in the GP sample. The patients' ratings of care were significantly more positive (mean 4.0) than those of the GPs (mean 3.7) as well as GPs' perceptions of patients' evaluations (mean 3.5) (p<0.001). The overall rank order correlations between the patients' evaluations, GPs' evaluations, and GPs' perceptions of the patients' evaluations were 0.75 or higher (p<0.001). Patients and practitioners gave the most positive evaluations of specific aspects of the doctor-patient relationship ("keeping patients' records and data confidential", "listening to patients", and "making patients feel they had enough time during consultations") and aspects of the organisation of care ("provide quick service for urgent health problems" and "helpfulness of the staff (other than the doctor)"). The aspects of care evaluated least positively by patients as well as by GPs were other organisational aspects ("preparing patients for what to expect from specialist or hospital care" and "getting through to practice on the telephone").
GPs and patients have to some extent a shared perspective on general practice care. However, GPs were more critical about the quality of care than patients and they underestimated how positive patients were about the care they provide. Furthermore, specific aspects of care were evaluated differently, so surveys and other consultations with patients are necessary to integrate their perspective into quality improvement activities.
比较患者和全科医生（GP）对全科医疗服务质量的评价。
对患者和全科医生进行书面调查。
荷兰的全科医疗。
1772名患者（来自45名全科医生）和315名全科医生的随机样本。
患者和全科医生对全科医疗服务23个方面的评价，以及全科医生对患者评价的认知，采用5分制。
患者样本的回复率为88%，全科医生样本的回复率为63%。患者对医疗服务的评分（平均4.0）明显高于全科医生（平均3.7）以及全科医生对患者评价的认知（平均3.5）（p<0.001）。患者评价、全科医生评价以及全科医生对患者评价的认知之间的总体等级相关系数为0.75或更高（p<0.001）。患者和从业者对医患关系的特定方面（“对患者记录和数据保密”、“倾听患者意见”以及“让患者觉得会诊时有足够时间”）和医疗服务组织方面（“为紧急健康问题提供快速服务”以及“工作人员（医生以外）的帮助程度”）给予了最积极的评价。患者和全科医生评价最低的医疗服务方面是其他组织方面（“让患者为专科或医院护理的预期做好准备”以及“通过电话联系诊所的难易程度”）。
全科医生和患者在一定程度上对全科医疗服务有共同的看法。然而，全科医生对医疗服务质量的批评比患者更多，并且他们低估了患者对他们所提供医疗服务的积极程度。此外，对医疗服务的特定方面评价不同，因此有必要进行调查以及与患者进行其他咨询，以便将他们的观点纳入质量改进活动中。
