Norwegian Institute of Public Health, PO Box 222, Skøyen, Oslo, NO-0213, Norway.
BMC Prim Care. 2024 Jul 10;25(1):249. doi: 10.1186/s12875-024-02495-1.
Patient experience is an important indicator of the quality of healthcare. Patients with multimorbidity often face adverse health outcomes and increased healthcare utilisation. General practitioners play a crucial role in managing these patients. The main aim of our study was to perform an in-depth assessment of differences in patient-reported experience with general practice between patients living with chronic conditions and multimorbidity, and those with no chronic conditions.
We performed secondary analyses of a national survey of patient experience with general practice in 2021 (response rate 41.9%, n = 7,912). We described the characteristics of all survey respondents with no, one, two, and three or more self-reported chronic conditions. We assessed patient experience using four scales from the Norwegian patient experience with GP questionnaire (PEQ-GP). These scales were used as dependent variables in bivariate and multivariate analyses and for testing the measurement model, including confirmatory factor analysis and a multigroup CFA to assess measurement invariance. Sentiment and content analysis of free-text comments was also performed.
Patients with chronic conditions consistently reported lower scores on the GP and GP practice experience scales, compared to those without chronic conditions. This pattern persisted even after adjustment for patient background variables. The strongest associations were found for the scale of "Enablement", followed by the scales of "GP" and "Practice". The subscale "Accessibility" did not correlate statistically significantly with any number of chronic conditions. The analysis of free-text comments echoed the quantitative results. Patients with multimorbidity stressed the importance of time spent on consultations, meeting the same GP, follow-up and relationship more often than patients with no chronic conditions. Our study also confirmed measurement invariance across patients with no chronic conditions and patients with multimorbidity, indicating that the observed differences in patient experience were a result of true differences, rather than artifacts of measurement bias.
The findings highlight the need for the healthcare system to provide customised support for patients with chronic conditions and multimorbidity. Addressing the specific needs of patients with multimorbidity is a critical step towards enhancing patient experience and the quality of care in general practice.
患者体验是医疗保健质量的重要指标。患有多种合并症的患者通常面临不良的健康结果和增加的医疗保健利用。全科医生在管理这些患者方面发挥着至关重要的作用。我们研究的主要目的是深入评估患有慢性疾病和多种合并症的患者与无慢性疾病的患者在对全科医生的体验方面的差异。
我们对 2021 年进行的一项全国性全科医生患者体验调查（回应率为 41.9%，n=7912）进行了二次分析。我们描述了所有自我报告有、无、一、两种或三种以上慢性疾病的调查受访者的特征。我们使用挪威全科医生患者体验问卷（PEQ-GP）的四个量表评估患者体验。这些量表在单变量和多变量分析中作为因变量使用，用于测试测量模型，包括验证性因素分析和多组 CFA，以评估测量不变性。我们还对自由文本评论进行了情感和内容分析。
患有慢性疾病的患者在 GP 和 GP 实践体验量表上的得分始终低于无慢性疾病的患者。即使在调整了患者背景变量后，这种模式仍然存在。最强的关联见于“赋权”量表，其次是“GP”和“实践”量表。“可及性”子量表与任何数量的慢性疾病均无统计学显著相关性。自由文本评论的分析与定量结果相呼应。患有多种合并症的患者比无慢性疾病的患者更经常强调咨询时间、与同一位 GP 见面、随访和关系的重要性。我们的研究还证实了无慢性疾病的患者和患有多种合并症的患者之间的测量不变性，这表明患者体验的差异是真实差异的结果，而不是测量偏差的人为产物。
研究结果强调需要为患有慢性疾病和多种合并症的患者提供定制的支持。满足多种合并症患者的特定需求是提高患者体验和全科医生护理质量的关键步骤。
