[Influence of the organizational model on user satisfaction].

OBJECTIVE

To identify in Health Centres (HC), doctors' offices and out-patient clinics the variables among the use, the doctor and organisation, which most affect satisfaction of the Primary Care (PC) user.

DESIGN

A descriptive crossover study.

SETTING

PC level in three Andalusian cities.

PATIENTS AND OTHER PARTICIPANTS

A sample of groups of 460 users of out-patient clinics and doctors' offices and 400 from HCs, all in an urban environment.

MEASUREMENTS AND MAIN RESULTS

Three questionnaires were used to gather the independent variables of organisation, doctor and use, and also the dependent variable, or satisfaction, in three dimensions: professional competence, personal qualities and accessibility. The reliability of the scale of satisfaction was analysed using Crombach's alpha; and discriminative capacity, using the Edwards test. The effect of the variables of doctor, user and organisation on HCs and doctors' offices / out-patient clinics was analysed separately with multiple regression. The determination coefficient of the variables for the user at doctors' offices / out-patient clinics was higher than the same variables in HCs (p < 0.0001), age being the variable which most affected satisfaction, both in HCs and doctors' offices / out-patient clinics. The determination coefficients for the regressions of the variables of doctor and organisation were higher in HCs than in doctors' offices / outpatient clinics (p < 0.001) in both cases - with the use of the clinical records being the primary variable in both organisations.

CONCLUSIONS

It appears that the organisational model of HCs offers more possibilities of increasing user satisfaction by modifying determined features of the doctor and the organisation.