Oleszczyk Marek, Krztoń-Królewiecka Anna, Schäfer Willemijn L A, Boerma Wienke G W, Windak Adam
Department of Family Medicine, Chair of Internal Medicine and Gerontology, Jagiellonian University Medical College, 4 Bochenska St., 31-061, Krakow, Poland.
NIVEL, Netherlands Institute for Health Services Research, PO Box 1568, 3500, BN, Utrecht, the Netherlands.
BMC Fam Pract. 2017 Nov 22;18(1):93. doi: 10.1186/s12875-017-0665-6.
Patients as real healthcare system users are important observers of primary care and are able to provide reliable information about the quality of care. The aim of this study was to explore the patients' experiences and their level of satisfaction with the process and outcomes of care provided by primary care physicians in Poland and to identify the characteristics of the patients, their physicians, and facilities associated with patient satisfaction.
The study is based on data from the Polish part of the Quality and Costs of Primary Care in Europe (QUALICOPC) cross-sectional, questionnaire-based study. In Poland, a nationally representative sample of 220 PC physicians and 1980 of their patients were recruited to take part in the study. As a study tool we used 3 out of 4 QUALICOPC questionnaires: "Patient Experience", "PC Physician" and "Fieldworker" questionnaires.
The areas of the best quality perceived by Polish PC patients are: equity, accessibility of care and quality of service. Coordination and comprehensiveness of care are evaluated relatively worse. The patients' and their physicians' characteristics have a limited influence on patient satisfaction and experiences with Polish primary care.
Primary health care in Poland is of good overall quality as perceived by the patients. Study participants were at most satisfied with accessibility and equity of care and less satisfied with coordination and comprehensiveness of care. Longer patient-doctor relationship and older age of patients were found as the most influential determinants of higher satisfaction. However, variables used in this study poorly explain the overall level of satisfaction. Further research is needed to identify the other determinants of patient satisfaction in the Polish population. Rural practices deserve additional attention due to highest proportions of both extremely satisfied and dissatisfied patients.
患者作为医疗保健系统的实际使用者，是初级保健的重要观察者，能够提供有关医疗质量的可靠信息。本研究的目的是探讨波兰患者对初级保健医生提供的护理过程和结果的体验及其满意度，并确定与患者满意度相关的患者、医生和医疗机构的特征。
本研究基于欧洲初级保健质量与成本（QUALICOPC）横断面问卷调查研究中波兰部分的数据。在波兰，招募了220名初级保健医生及其1980名患者的具有全国代表性的样本参与研究。作为研究工具，我们使用了QUALICOPC四份问卷中的三份：“患者体验”、“初级保健医生”和“现场工作人员”问卷。
波兰初级保健患者认为质量最佳的领域是：公平性、医疗可及性和服务质量。护理的协调性和全面性评价相对较差。患者及其医生的特征对波兰初级保健患者的满意度和体验影响有限。
波兰患者认为初级卫生保健的总体质量良好。研究参与者对医疗的可及性和公平性最为满意，对护理的协调性和全面性不太满意。发现较长的医患关系和患者年龄较大是满意度较高的最具影响力的决定因素。然而本研究中使用的变量对总体满意度的解释力较差。需要进一步研究以确定波兰人群中患者满意度的其他决定因素。由于极度满意和不满意患者的比例最高，农村医疗机构值得额外关注。
