Satisfied doctors ... satisfied patients?: the relationship between patient-, GP-and practice characteristics and the quality of care ratings of patients.

Background: Quality of care from the patients’ perspective can be seen as a key element of health care policy and the management of health care services. Aim: The aims of this paper are twofold. 1) To look at differences in the quality of care ratings of GP patients. 2) To explore the relationship between quality of care ratings and the characteristics of patients, GPs and general practice. Methods: Quality of care scores relate to 22 aspects included in the QUOTEGP instrument and derived from a random sample of 12,699 patients. Interview data were linked to the results of a questionnaire completed by 195 GPs working in 126 practices. Patients were nested within GPs and/or GP practices. Data were collected in 2001 and analysed in a two-level regression analysis. Results: On average, 17% of the respondents reported insufficient quality of care. Process quality was perceived as ‘poor’ by 11% of the sample; structure quality was reported as ‘absent’ by 25% of the sample. On 1-4 scale, overall quality scores varied between 3.04 and 3.59. On the GP-level, job satisfaction and feelings of burnout were significantly related to the quality of care scores of patients. On the patient level, quality of care scores were related to age, health status and psychological wellbeing. Conclusions: Although patients are usually very satisfied with their GP, differences between GPs and relatively low scores for structure quality suggest that further quality improvement on specific aspects is possible. Activities to increase job satisfaction and decrease burnout levels among GPs might result in even more satisfied patients