Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-28T14:24:23.037Z Has data issue: false hasContentIssue false
  • English
  • Français

Is patient satisfaction in primary care dependent on structural and organizational characteristics among providers? Findings based on data from the national patient survey in Sweden

Published online by Cambridge University Press:  08 October 2012

Anna H. Glenngård
Anna H. Glenngård*
Affiliation:
1Lund University School of Economics and Management, Lund, Sweden2The Swedish Institute for Health Economics (IHE), Lund, Sweden
*
*Correspondence to: Anna H. Glenngård, Lund University School of Economics and Management, PO Box 7080, 22007 Lund, Sweden. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

In parallel to market-like reforms in Swedish primary care, the gathering and compilation of comparative information about providers, for example through survey tools, has been improved. Such information is increasingly being used to guide individuals’ choice of provider and payers’ assessments of provider performance, often without critically reflecting about underlying factors affecting the results. The purpose of this study was to analyze variation in patient satisfaction, with respect to organizational and structural factors, including the mix of registered individuals, among primary care providers, based on information from a national patient survey in primary care and register data in three Swedish county councils. Systematic variation in patient satisfaction was found with respect to both organizational and structural factors, including characteristics of registered individuals. Smaller practices and practices where a high proportion of all visits were with a doctor were associated with higher patient satisfaction. Also practices where registered individuals had a low level of social deprivation and a high overall illness on average were associated with higher patient satisfaction. Factors that are of relevance for how well providers perform according to patient surveys are more or less possible to control for providers. This adds to the complexity for the use of such information by individuals and payers to assess provider performance.

Type
Articles
Information
Health Economics, Policy and Law , Volume 8 , Issue 3 , July 2013 , pp. 317 - 333
Copyright
Copyright © Cambridge University Press 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anell, A. (2011), ‘Choice and privatisation in Swedish primary care’, Health Economics, Policy and Law, 6: 549–569.CrossRefGoogle ScholarPubMed
Anell, A., Rosén, P.Hjortsberg, C. (1997), ‘Choice and participation in the health services: a survey of preferences among Swedish residents’, Health Policy, 40: 157–168.Google Scholar
Barnum, H., Kutzin, J.Saxenian, H. (1995), ‘Incentives and provider payments methods’, International Journal of Health Planning and Management, 10: 23–45.Google ScholarPubMed
Barr, D. A., Fenton, L.Blane, D. (2008), ‘The claim for patient choice and equity’, Journal of medical ethics, 34: 271–274.Google Scholar
Bevan, G., Helderman, J. K.Wilsford, D. (2010), ‘Changing choices in health care: implications for equity, efficiency and cost’, Health economics policy and law, 5: 251–267.Google Scholar
Browne, K., Roseman, D., Shaller, D.Edgman-Levitan, S. (2010), ‘Analysis & commentary. Measuring patient experience as a strategy for improving primary care’, Health Affairs (Millwood), 29(5): 921–925.Google Scholar
Campbell, J. L., Ramsay, J.Green, J. (2001a), ‘Practice size: impact on consultation length, workload, and patient assessment of care’, The British Journal of General Practice, 51(469): 644–650.Google ScholarPubMed
Campbell, J. L., Ramsay, J.Green, J. (2001b), ‘Age, gender, socioeconomic, and ethnic differences in patients’ assessments of primary health care’, Quality in Health Care, 10(2): 90–95.Google Scholar
Cutler, D. (2002), ‘Equality, efficiency and market fundamentals: The dynamics of international medical-care reform’, Journal of Economic Literature, 40(3): 881–906.Google Scholar
Dixon, A.Le Grand, J. (2006), ‘Is greater patient choice consistent with equity? The case of the English NHS’, Journal of Health Services Research and Policy, 11: 162–166.Google Scholar
Fotaki, M., Roland, M., Boyd, A., McDonald, R., Scheaff, R.Smith, L. (2008), ‘What benefits will choice bring to patients? Literature review and assessment of implications’, Journal of Health Services Research and Policy, 13: 178–184.Google Scholar
Glenngård, A., Anell, A.Beckman, A. (2011), ‘Choice of primary care provider: results from a population survey in three Swedish counties’, Health Policy, 103(1): 31–37.Google Scholar
Greiling, D., Spraul, K. (2010), ‘Accountability and the challenges of information disclosure’, Public Administration Quarterly, 338–375.Google Scholar
Hibbard, J. H.Peters, E. (2003), ‘Supporting informed consumer health care decisions: data presentation approaches that facilitate the use of information in choice’, Annual Reviews of Public Health, 24: 413–433.CrossRefGoogle ScholarPubMed
Hill, C., Griffiths, W.Judge, G. (1997), Undergraduate Econometrics, New York: John Wiley & Sons.Google Scholar
Hjelmgren, J.Anell, A. (2007), ‘Population preferences and choice of primary care models: a discrete choice experiment in Sweden’, Health Policy, 83: 314–322.Google Scholar
Institute for Quality Indicators (2011), www.indikator.org and personal communication Johan Frisack Indikator, March, April, October.Google Scholar
Jegers, M., Kesteloot, K., De Graeve, D., Gilles, W. (2002), ‘A typology for provider payment systems in health care’, Health Policy, 60: 255–273.Google Scholar
Jessup, R. L. (2007), ‘Interdisciplinary versus multidisciplinary care teams: do we understand the difference?’, Australian Health Review, 31(3): 330–331.CrossRefGoogle ScholarPubMed
Kontopantelis, E., Roland, M.Reeves, D. (2010), ‘Patient experience of access to primary care: identification of predictors in a national patient survey’, BMC Family Practice, 11(61): 1–15.Google Scholar
Lamarche, P. A., Beaulieu, M., Pineault, R., Contandriopoulos, A., Denis, J., Haggerty, J. (2003), Choices for Change: The Path for Restructuring Primary Healthcare Services in Canada. Canadian Health Services Research Foundation, New Brunswick Department of Health and Wellness, Saskatchewan Department of Health, Ministère de la santé et des services sociaux du Québec and Health Canada, November.Google Scholar
Le Grand, J. (2007), ‘Delivering Public Services Through Choice and Competition – The Other Invisible Hand’, Princeton: Princeton University Press.Google Scholar
Le Grand, J. (2009), ‘Choice and competition in publicly funded health care’, Health Economics Policy and Law, 4: 479–488.Google Scholar
Miller, H. (2009), How to Create Accountable Care Organizations, Pittsburgh: Center for Healthcare Quality and Payment Reform.Google Scholar
Nordgren, L., Åhgren, B. (2010), Val av primärvård: resultat från en brukarundersokning baserad på invånarepaneler [Choice in primary care. Results from a study based on group interviews], Konkurrensverket Uppdragsforskningsrapport, 3.Google Scholar
Pallant, J. (2007), SPSS Survival Manual 3rd edition: A Step By Step Guide to Data Analysis Using SPSS. Buckingham: Open University Press.Google Scholar
Reid, R., MacWilliam, L., Roos, N. P., Bogdanovic, B., Black, C. (1999), Measuring morbidity in populations: performance of the Johns Hopkins Adjusted Clinical Group (ACG) Case-Mix Adjustment System in Manitoba. Winnipeg: Manitoba Centre for Health Policy and Evaluation Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, June.Google Scholar
Smith, P. C., Mossialos, E., Papanicolas, I.Leatherman, S. (2010), Performance Measurement for Health System Improvement: Experiences, Challenges and Prospects, Cambridge: Cambridge University Press.Google Scholar
Smith, P., Anell, A., Busse, R., Crivelli, L., Healy, J., Lindahl, A., Westert, G.Kene, T. (2012), ‘Leadership and governance in seven developed health systems’, Health Policy, 106(1): 37–49.Google Scholar
Starfield, B. (1998), Primary Care: Balancing Health Needs, Services and Technology, New York: Oxford University Press.Google Scholar
Sundquist, K., Malmström, M., Johansson, S. E.Sundquist, J. (2003), ‘Care Need Index, a useful tool for the distribution of primary health care resources’, Journal of Epidemiology and Community Health, 57: 347–352.Google Scholar
Swedish Association of Local Authorities and Regions (SALAR) (2011), [Sveriges Kommuner och Landsting, SKL]: http://www.npe.skl.se [28 August 2011].Google Scholar
Swedish Competition Authority (2010). ‘Uppfoljning av vårdval i primärvården -Valfrihet, mångfald och etableringsforutsättningar. Slutrapport [Study of privatization and choice in primary care]’, Final report, Stockholm: Konkurrensverket, 3.Google Scholar
World Health Organization (WHO) (2000), World Health Report, Geneva: World Health Organization.Google Scholar
Yarnall, K. S. H., Østbye, T., Krause, K. M., Pollak, K. I., Gradison, M.Michener, J. L. (2009), ‘Family physicians as team leaders: “time” to share the care’, Preventing Chronic Diseases, 6(2), http://www.cdc.gov/pcd/issues/2009/apr/08_0023.htm [19 September 2011].Google Scholar