AGE-DIFFERENCES IN WOMENS VERDICTS ON THE QUALITY OF PRIMARY HEALTH-CARE SERVICES

Background. One aim of the Patients' Charter initiative is to ensure t hat general practitioner (GP) services become more sensitive to the ex pressed needs of patients. Most studies in this area have concentrated on the personal and professional attributes of the GP, and few studie s have explored in detail the specific views of women patients. Aim. T o examine age differences in the views of women under the age of 65 ye ars on the quality of different aspects of primary health care service s. Method. 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. Results. There i s a strong inverse relationship between age and negative evaluations o f primary health care services. On each of 20 items ['what are the wor st things about the GP surgery?'], older women consistently scored low er 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 n ine 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 sig nificant age difference, and on the item with the highest overall posi tive ranking, 'not far to travel to GP surgery', the association was i n the opposite direction to that expected, i.e. a larger proportion of women under 40 years of age (72.5%) answered positively than did wome n over the age of 40 years (64.9%). Conclusions. It is likely that the relationship between age and positive evaluations of primary health c are service is less straightforward than has been assumed previously. Although older women are consistently less willing to criticize primar y health care services across the board, they are more discriminating in giving and withholding praise.