Patients in Europe evaluate general practice care: an international comparison

Background. Patients' evaluations can be used to improve health care and co mpare general practice in different health systems. Aim. To identify aspects of general practice that are generally evaluated p ositively by patients and to compare opinions of patients in different Euro pean countries on actual care provision. Method. An internationally-validated questionnaire was distributed to and c ompleted by patients in 10 European countries. A stratified sample of 36 pr actices per country, with at least 1080 patients per country, was included. A set of 23 validated questions on evaluations of different aspects of car e was used, as well as questions on age, sex, overall health status, and fr equency of visiting the GP. Results. The patient sample included 17 397 patients in 10 different countr ies; the average response rate was 79% (range = 67% to 89%). In general, pa tients visiting their general practitioner (GP) were very positive about th e care provided. For most of the 23 selected aspects of care more than 80% viewed care as good or excellent; in particular, keeping records confidenti al, GP listening to patients, time during consultations, and quick services in case of urgent problems were evaluated positively. Patients were relati vely negative about organisational aspects of care. The evaluations in diff erent countries were largely similar, with some interesting differences; fo r instance, service and organisational aspects were evaluated more positive ly in fee-for-service health systems. Conclusions. Patients in Europe are positive about general practice but imp rovements in practice management in some countries are requested. More rese arch is needed to study the complex field of differences in expectations an d evaluations between countries with different health systems.