Older patients’ satisfaction and length of visit in primary care – what influences this?

Abstract

Background: Patients’ satisfaction (PS) is frequently used to assess the effectiveness of medical care; this is in contrast to primary care (PC) capacity measures imposing strict limits of time spent per visit. Setting out to challenge stereotypes on elderly patients’ visits in PC, the aim of the present study is to identify relationships between PS, length of visit (LOV) and basic factors characterising patients, doctors and facilities. Method: Score on PRACTA – Patient Satisfaction with the Visit Scale (PRACTA-PSVS) and the LOV were the outcomes from a larger PRACTA-promoting active aging study database (patients n=8862, age 50-98 and PC doctors n=503). Independent variables included the patient’s social and health status, the doctor’s work satisfaction or the fluctuation of staff within a given facility. Findings: Preliminary analysis, using the General Linear Model (GENLIN), showed that the factors from all three mentioned categories contributed to PRACTA-PSVS and the LOV, e.g. the doctor’s satisfaction with work (Wald χ²=15,85, p<0,001 and Wald χ²=15,68, p<001 respectively) and the fluctuation of staff (Wald χ²=25,17, p<0,001 and Wald χ²=12,99, p=0,005). Interestingly, age of the patient had no effect on both outcomes, and the LOV was only marginally and negatively related to PS (Wald χ²=5,63, p=0,018, B=-0,008). Discussion: PS and LOV are determined by a number of factors originating from doctor’s and facility’s characteristics which is higher than those describing the patients. Nevertheless, when aiming at improving PC efficacy for older adults, specific PS and LOV related factors concerning patients, doctors and facilities should be carefully considered.