title: Gynaecology: the experience of patients referred to NHS and private clinics.
abstract: This cohort study compared the experience of patients seeking treatment for menorrhagia who were referred to National Health Service (NHS) or private clinics. Two-hundred and nine patients in 73 general practices in Berkshire, Buckinghamshire, Northamptonshire and Oxfordshire were recruited by their general practitioners and followed-up with questionnaires at nine months and 18 months after entry to the study. One hundred and fifty patients were referred to NHS clinics and 59 to private clinics; there were no significant differences between the two groups of patients in terms of symptom severity, reason for referral or treatment received. Patients who went to private clinics were more likely to report active participation in decisions about their care (p < 0.05 after adjustment for age and educational status), and were slightly more likely to be satisfied with the care they had received. The treatment decisions made in gynaecological clinics in the NHS and private sector were similar, but the decision-making styles appeared to be different. Private patients were more likely to participate in treatment decisions than NHS patients.
authors.affiliation: King's Fund Development Centre, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Coulter
authors.forename: V
authors.initials: V
authors.lastname: Peto
authors.forename: H
authors.initials: H
authors.lastname: Doll
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities / Q000592:standards*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007348:Insurance, Health; D008595:Menorrhagia / Q000601:surgery*; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D017149:Private Sector; D011446:Prospective Studies; D012017:Referral and Consultation; D013222:State Medicine / Q000592:standards*; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology