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.