Abstract

Background. Patient experience and satisfaction are important indicators of quality in health care.
Little is known about where to prioritize efforts to improve patient satisfaction.
Objectives. To investigate patient satisfaction with primary care, as part of the Quality and Costs
of Primary Care in Europe study in England, identifying areas where improvements could be made
from patients’ perspectives.
Methods. We conducted a questionnaire survey of general practice patients in three English regions.
Patient Values questionnaires assessed what patients thought was important, and Patient Experience
questionnaires rated performance of primary care. Fifteen attributes of care were compared using
Importance Performance Analysis, a method that simultaneously represents data on importance
and performance of a service, enabling identification of its strengths and weaknesses.
Results. Patients rated both ‘relational’ and ‘functional’ aspects of care as important. Satisfaction with
general practice could be improved by concentrating on specific aspects of access (ensuring that patients
know how to access out-of-hours services and find it easy to get an appointment), and one aspect
of empowerment (after their visit, patients feel able to cope better with their health problem/illness).
However, for other attributes (e.g. proximity of the practice to a patient’s house or, a short waiting time
when contacting the practice), investing additional resources is not likely to increase patient satisfaction.
Conclusion. Attributes needing most improvement concerned access to primary care and patient
empowerment. More research is needed to identify how to improve access without generating
unnecessary additional demand or compromising continuity of care.