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英国一项观察性研究:全科医疗预约量与预约类型和患者体验之间的关系

Relationship between the volume and type of appointments in general practice and patient experience: an observational study in England.

作者信息

Burch Patrick, Whittaker William, Lau Yiu-Shing

机构信息

Centre for Primary Care, University of Manchester, Manchester.

Public Health, Policy & Systems, University of Liverpool, Liverpool.

出版信息

Br J Gen Pract. 2025 May 2;75(754):e375-e381. doi: 10.3399/BJGP.2024.0276. Print 2025 May.

Abstract

BACKGROUND

Patient satisfaction is a significant dimension of quality in general practice and has notably declined post-COVID. Understanding the dynamics between practice activities, practice characteristics, and patient experience is vital for improving care quality.

AIM

To investigate the relationship between the volume, modality (telephone or face to face), and practitioner type of general practice appointments and patient experience.

DESIGN AND SETTING

This was an observational study of general practices in England.

METHOD

Data from the GP Patient Survey (GPPS) were merged with NHS England's practice-level appointment data, covering August 2022 to March 2023. Ordinary least squares regressions were estimated of patient satisfaction with access, general satisfaction, preference for a specific GP, and support for managing long-term conditions (dependent variables) against appointment volume, modality (telephone or face to face), and practitioner type.

RESULTS

Analysis of 5278 practices showed that a higher volume of appointments, especially face to face with GPs, was significantly (<0.001) associated with increased patient satisfaction. Practices having a greater proportion of same-day appointments was significantly correlated with lower patient satisfaction.

CONCLUSION

Patient satisfaction and ability to have health needs met is associated with face-to-face access to GPs as well as the total volume of appointments available. The results suggest that patients' perceptions of access involve more than immediate availability of appointments or that patients may struggle to get appointments at practices offering more same-day appointments. Initiatives to improve access to, and satisfaction with, general practice should prioritise expanding face-to-face GP appointments.

摘要

背景

患者满意度是全科医疗质量的一个重要维度,且在新冠疫情后显著下降。了解医疗活动、医疗特征和患者体验之间的动态关系对于提高医疗质量至关重要。

目的

调查全科医疗预约的数量、方式(电话或面对面)和从业者类型与患者体验之间的关系。

设计与设置

这是一项对英格兰全科医疗的观察性研究。

方法

将家庭医生患者调查(GPPS)的数据与英国国家医疗服务体系(NHS)英格兰地区的医疗层面预约数据合并,涵盖2022年8月至2023年3月。针对预约数量、方式(电话或面对面)和从业者类型,对患者在就诊机会、总体满意度、对特定家庭医生的偏好以及对长期疾病管理的支持(因变量)方面的满意度进行普通最小二乘法回归估计。

结果

对5278家医疗机构的分析表明,预约数量越多,尤其是与家庭医生面对面预约,与患者满意度提高显著相关(<0.001)。当日预约比例较高的医疗机构与患者满意度较低显著相关。

结论

患者满意度以及满足健康需求的能力与与家庭医生面对面就诊以及可提供的预约总量相关。结果表明,患者对就诊机会的认知不仅仅涉及预约的即时可得性,或者患者可能在提供更多当日预约的医疗机构难以获得预约。改善全科医疗就诊机会和满意度的举措应优先考虑增加与家庭医生面对面的预约。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6548/12040365/4246b1fd2efd/bjgpmay-2025-75-754-e375-1.jpg

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