Experiences of adult patients using primary care services in Poland – a cross-sectional study in QUALICOPC study framework

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Abstract

Background

Patients as real healthcare system users are important observers of primary care and are able to provide reliable information about the quality of care. The aim of this study was to explore the patients’ experiences and their level of satisfaction with the process and outcomes of care provided by primary care physicians in Poland and to identify the characteristics of the patients, their physicians, and facilities associated with patient satisfaction.

Methods

The study is based on data from the Polish part of the Quality and Costs of Primary Care in Europe (QUALICOPC) cross-sectional, questionnaire-based study. In Poland, a nationally representative sample of 220 PC physicians and 1980 of their patients were recruited to take part in the study. As a study tool we used 3 out of 4 QUALICOPC questionnaires: “Patient Experience”, “PC Physician” and “Fieldworker” questionnaires.

Results

The areas of the best quality perceived by Polish PC patients are: equity, accessibility of care and quality of service. Coordination and comprehensiveness of care are evaluated relatively worse. The patients’ and their physicians’ characteristics have a limited influence on patient satisfaction and experiences with Polish primary care.

Conclusions

Primary health care in Poland is of good overall quality as perceived by the patients. Study participants were at most satisfied with accessibility and equity of care and less satisfied with coordination and comprehensiveness of care. Longer patient-doctor relationship and older age of patients were found as the most influential determinants of higher satisfaction. However, variables used in this study poorly explain the overall level of satisfaction. Further research is needed to identify the other determinants of patient satisfaction in the Polish population. Rural practices deserve additional attention due to highest proportions of both extremely satisfied and dissatisfied patients.

Electronic supplementary material

The online version of this article (10.1186/s12875-017-0665-6) contains supplementary material, which is available to authorized users.

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Most cited references 32

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The Quality of Care

Avedis Donabedian (1988)

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The breadth of primary care: a systematic literature review of its core dimensions

Dionne S. Kringos, Wienke Boerma, Allen Hutchinson … (2010)

Background Even though there is general agreement that primary care is the linchpin of effective health care delivery, to date no efforts have been made to systematically review the scientific evidence supporting this supposition. The aim of this study was to examine the breadth of primary care by identifying its core dimensions and to assess the evidence for their interrelations and their relevance to outcomes at (primary) health system level. Methods A systematic review of the primary care literature was carried out, restricted to English language journals reporting original research or systematic reviews. Studies published between 2003 and July 2008 were searched in MEDLINE, Embase, Cochrane Library, CINAHL, King's Fund Database, IDEAS Database, and EconLit. Results Eighty-five studies were identified. This review was able to provide insight in the complexity of primary care as a multidimensional system, by identifying ten core dimensions that constitute a primary care system. The structure of a primary care system consists of three dimensions: 1. governance; 2. economic conditions; and 3. workforce development. The primary care process is determined by four dimensions: 4. access; 5. continuity of care; 6. coordination of care; and 7. comprehensiveness of care. The outcome of a primary care system includes three dimensions: 8. quality of care; 9. efficiency care; and 10. equity in health. There is a considerable evidence base showing that primary care contributes through its dimensions to overall health system performance and health. Conclusions A primary care system can be defined and approached as a multidimensional system contributing to overall health system performance and health.

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The strength of primary care in Europe: an international comparative study.

Dionne Sofia Kringos, Wienke Boerma, Yann Bourgueil … (2013)

A suitable definition of primary care to capture the variety of prevailing international organisation and service-delivery models is lacking. Evaluation of strength of primary care in Europe. International comparative cross-sectional study performed in 2009-2010, involving 27 EU member states, plus Iceland, Norway, Switzerland, and Turkey. Outcome measures covered three dimensions of primary care structure: primary care governance, economic conditions of primary care, and primary care workforce development; and four dimensions of primary care service-delivery process: accessibility, comprehensiveness, continuity, and coordination of primary care. The primary care dimensions were operationalised by a total of 77 indicators for which data were collected in 31 countries. Data sources included national and international literature, governmental publications, statistical databases, and experts' consultations. Countries with relatively strong primary care are Belgium, Denmark, Estonia, Finland, Lithuania, the Netherlands, Portugal, Slovenia, Spain, and the UK. Countries either have many primary care policies and regulations in place, combined with good financial coverage and resources, and adequate primary care workforce conditions, or have consistently only few of these primary care structures in place. There is no correlation between the access, continuity, coordination, and comprehensiveness of primary care of countries. Variation is shown in the strength of primary care across Europe, indicating a discrepancy in the responsibility given to primary care in national and international policy initiatives and the needed investments in primary care to solve, for example, future shortages of workforce. Countries are consistent in their primary care focus on all important structure dimensions. Countries need to improve their primary care information infrastructure to facilitate primary care performance management.

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Author and article information

Contributors

Marek Oleszczyk:

ORCID: http://orcid.org/0000-0002-8042-6188

marek.oleszczyk@uj.edu.pl

Anna Krztoń-Królewiecka: akrolewiecka@gmail.com

Willemijn L. A. Schäfer: willemijnschafer@gmail.com

Wienke G. W. Boerma: w.boerma@nivel.nl

Adam Windak: mmwindak@cyf-kr.edu.pl

Journal

Journal ID (nlm-ta): BMC Fam Pract

Journal ID (iso-abbrev): BMC Fam Pract

Title: BMC Family Practice

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2296

Publication date (Electronic): 22 November 2017

Publication date PMC-release: 22 November 2017

Publication date Collection: 2017

Volume: 18

Electronic Location Identifier: 93

Affiliations

[1 ]ISNI 0000 0001 2162 9631, GRID grid.5522.0, Department of Family Medicine, Chair of Internal Medicine and Gerontology, , Jagiellonian University Medical College, ; 4 Bochenska St., 31-061, Krakow, Poland

[2 ]ISNI 0000 0001 0681 4687, GRID grid.416005.6, NIVEL, Netherlands Institute for Health Services Research, ; PO Box 1568, 3500 BN Utrecht, the Netherlands

Author information

Marek Oleszczyk http://orcid.org/0000-0002-8042-6188

Article

Publisher ID: 665

DOI: 10.1186/s12875-017-0665-6

PMC ID: 5700756

PubMed ID: 29166872

SO-VID: 69106b42-b3b7-464e-9bc8-647006f001f3

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 29 August 2017

Date accepted : 15 November 2017

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100000780, European Commission;

Award ID: 242141

Custom metadata

ScienceOpen disciplines: Medicine

Keywords: primary health care,quality of health care,family medicine,patient satisfaction,poland

Data availability:

ScienceOpen disciplines: Medicine

Keywords: primary health care, quality of health care, family medicine, patient satisfaction, poland

Experiences of adult patients using primary care services in Poland – a cross-sectional study in QUALICOPC study framework

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Abstract

Background

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Annals of Family Medicine: COVID-19

Most cited references 32

The Quality of Care

The breadth of primary care: a systematic literature review of its core dimensions

The strength of primary care in Europe: an international comparative study.

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