Patient satisfaction with out-of-hours services; how do GP co-operatives compare with deputizing and practice-based arrangements?
BACKGROUND
Although the rapid growth in general practitioner (GP) co-operatives has met with GP satisfaction, little is known about patient satisfaction. This study compares patient satisfaction with co-operative, GP practice-based and deputizing arrangements within one geographical area 15 months after a co-operative had become established; and with telephone, primary care centre and home consultations within the co-operative.


METHODS
A validated postal questionnaire survey of weighted samples of patients making contact with the co-operative, practice-based and deputizing arrangements was undertaken.


RESULTS
A total of 1,823 (53.2 per cent) patients responded. There were no significant differences between organizations in terms of overall satisfaction, but patients using practice-based arrangements were significantly more satisfied with the waiting time for telephone consultations (p<0.001) and more satisfied with waiting times for home visits than deputizing patients (p=0.020). Within the co-operative, overall satisfaction, satisfaction with the doctor's manner and with the process of making contact was greater among those attending the primary care centre, and satisfaction with explanation and advice received greater than for patients receiving telephone consultations alone (p<0.01). Those receiving telephone advice reported increased information needs and help seeking during the following week (p< 0.05).


CONCLUSIONS
Overall, patients were as satisfied with the co-operative as with practice-based or deputizing service arrangements, although many concerns were expressed about the quality of service provision. Differences in satisfaction were greater between forms of service delivery within the co-operative. Dissatisfaction with telephone consultations needs to be considered, together with issues relating to equity in access to out-of-hours' primary care centre consultations and the potential impact of NHS Direct.
Shipman
C
C
Department of General Practice and Primary Care, Guy's King's and St Thomas' School of Medicine, London.
Payne
F
F
Hooper
R
R
Dale
J
J
D000368:Aged; D005194:Family Practice / Q000458:organization & administration*; D005260:Female; D006123:Group Practice / Q000458:organization & administration*; D006302:Health Services Research; D006792:House Calls; D006801:Humans; D008131:London; D008297:Male; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration*; D012017:Referral and Consultation / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D013689:Telephone; D013997:Time Factors; D014850:Waiting Lists