Doctor's care or self-care?: expectations of doctor's care in case of common self-limiting health ailments.

Background: According to the Health Belief Model, the patient's expectation of the benefit of medical care is an important factor influencing medical help seeking and satisfaction with care. Given developments in Western society, health care, and Dutch general practice, up-to-date information about patients' expectations is of importance for practice management and health care policy. Aim:The aim of this study is to gain insight in the expectations of the benefits of general practice care as compared to self-care in case of common self-limiting symptoms, as well as to evaluate to what extent patients' expectations have changed over the last 14 years. Methods:The Nijmegen Expectation Questionnaire (NEQ) was used to assess patients' expectations with regard to medical treatment as compared to self-care given non-severe health complaints. In the NEQ patients' expectations are operationalized in 12 items concerning possible benefits of consulting the general practitioner for various common symptoms. The NEQ was administered in 1987 and 2001 as a part of two Dutch national surveys of general practice. Both study samples were representative with regard to the general practices (1987:n=103, 2001:n=104) and patient population (1987:n=13.014, 2001:n=12.514). Results:Preliminary findings show that patients' expectations of doctor's care are significantly lower than 14 years ago (mean scores ±SD: 36,8 ±8,9 versus 41,2 ±7,7). Expectations and changes in expectations differ between symptoms. Compared to 14 years ago, people would consult the practitioner less to seek relief for a cold or sore throat, but equal or more in case of nervous complaints. Furthermore, expectations vary according to social and demographic variables. Conclusions: Patients' expectations vary between symptoms and have changed accordingly over time. The question will be addressed how the results of this study relate to increased (access to) medical knowledge, self-care, and past policy measures.(aut. ref.