Phillips D, Brooks F
Department of Sociological Studies, University of Sheffield.
Br J Gen Pract. 1998 Apr;48(429):1151-4.
One aim of the Patients' Charter initiative is to ensure that general practitioner (GP) services become more sensitive to the expressed needs of patients. Most studies in this area have concentrated on the personal and professional attributes of the GP, and few studies have explored in detail the specific views of women patients.
To examine age differences in the views of women under the age of 65 years on the quality of different aspects of primary health care services.
A random sample of 1251 women aged 16-65 years was surveyed by postal questionnaire on their use of and satisfaction with primary health care services. Analyses were undertaken of women's verdicts on the best and worst aspects of the services provided.
There is a strong inverse relationship between age and negative evaluations of primary health care services. On each of 20 items ['what are the worst things about the GP surgery?'], older women consistently scored lower than younger women. The results were not so clear-cut among the 20 positive items ('what are the best things about the GP surgery'). On nine items, there was a significant positive association with age (the highest being on 'receptionists are approachable' and 'practice nurse is approachable and easy to talk to'). On nine items, there was no significant age difference, and on the item with the highest overall positive ranking, 'not far to travel to GP surgery', the association was in the opposite direction to that expected, i.e., a larger proportion of women under 40 years of age (72.5%) answered positively than did women over the age of 40 years (64.9%).
It is likely that the relationship between age and positive evaluations of primary health care service is less straightforward than has been assumed previously. Although older women are consistently less willing to criticize primary health care services across the board, they are more discriminating in giving and withholding praise.
患者宪章倡议的一个目标是确保全科医生(GP)服务对患者表达的需求更加敏感。该领域的大多数研究都集中在全科医生的个人和专业属性上,很少有研究详细探讨女性患者的具体观点。
研究65岁以下女性对初级卫生保健服务不同方面质量的看法的年龄差异。
通过邮寄问卷对1251名年龄在16 - 65岁的女性进行随机抽样调查,询问她们对初级卫生保健服务的使用情况和满意度。对女性对所提供服务最佳和最差方面的评价进行了分析。
年龄与对初级卫生保健服务的负面评价之间存在强烈的负相关关系。在20项关于“全科医生诊所最糟糕的事情是什么?”的问题中,老年女性的得分始终低于年轻女性。在20项关于“全科医生诊所最好的事情是什么?”的正面问题中,结果并不那么明确。在9项问题上,与年龄存在显著的正相关(最高的是“接待员平易近人”和“执业护士平易近人且易于交谈”)。在9项问题上,没有显著的年龄差异,而在总体正面排名最高的问题“去全科医生诊所的路程不远”上,关联方向与预期相反,即40岁以下女性(72.5%)给出肯定回答的比例高于40岁以上女性(64.9%)。
年龄与对初级卫生保健服务的正面评价之间的关系可能比之前假设的要复杂。虽然老年女性总体上一直不太愿意批评初级卫生保健服务,但她们在给予和保留赞扬方面更具辨别力。