Age, gender, socioeconomic, and ethnic differences in patients' assessments of primary health care

Background-Patients' evaluations are an important means of measuring aspect s of primary care quality such as communication and interpersonal care. Thi s study aims to examine variations in assessments of primary care according to age, gender, socioeconomic, and ethnicity variables. Methods-A cross sectional survey of consecutive patients attending 55 inner London practices was performed over a 2 week period using the General Prac tice Assessment Survey (GPAS) instrument which assesses 13 important dimens ions of primary care provision. Variations in scale scores were investigate d for differences relating to age, gender, socioeconomic, and ethnic status as reported by respondents. Results-A total of 7692 questionnaires were returned (71% response rate). V alid information on age, gender, socioeconomic status, and ethnicity was av ailable for 4819 out of 5496 adult respondents. Approximately half the resp ondents reported their ethnic group as "white" and most of the remaining re spondents reported belonging to "black" or South Asian groups. Significant differences existed between groups of patients defined by age or ethnicity for most of the scale scores examined. Black, South Asian, and Chinese resp ondents reported lower scores (representing less favourable assessments) th an white respondents; older respondents reported more favourable evaluation s of care than younger respondents; and less affluent groups reported lower scores than more affluent groups for two of the 13 dimensions. There was n o significant difference between gender groups with respect to assessment o f primary care. Age and ethnicity were independent predictors of respondent s' assessments of primary care. Conclusions-Differences exist between identifiable subgroups of the populat ion in their assessments of primary health care measured using the GPAS ins trument. This work adds to the literature on variation in healthcare experi ence and the potential for patient assessment of primary care, Further work is required to investigate these differences in more detail and to relate them to differences in the nature and process of primary care provision. Pr imary care providers need to ensure that services provided are appropriate for all patient groups within their communities.