Patient satisfaction with out of hours primary medical care.
OBJECTIVE
To describe the relationship between patient satisfaction with out of hours care provided by deputising and practice doctors in four urban areas in England and characteristics of the service provided and patients, the care given, and health outcomes.


METHODS
-Fourteen general practices in four urban areas in England.


METHODS
People who requested out of hours care.


METHODS
Analysis of data from a study of out of hours care. Patients were interviewed within 5 days of their request for out of hours care. Data on the service provided were obtained from medical records and all other data were collected at interview. Satisfaction was measured using a valid reliable instrument.


RESULTS
2152 patients were recruited to the study and 1466 were interviewed. Satisfaction data were available on 1402 patients. "Overall satisfaction" was associated with age, doctor type, lack of access to a car at the time of the request, and health outcome. The relationships between satisfaction subscales and patient characteristics (age, sex, ethnicity, and access to a car at the time of the request), service characteristics (doctor type and delay between the request and visit), whether a prescription was given, and health outcome were variable. If an expected home visit was not received, "overall satisfaction" and satisfaction with "communication and management", "doctor's attitude", and "initial contact person" were reduced.


CONCLUSIONS
Patient satisfaction is dependent on many factors. Mismatch between patient expectation and the service received is related to decreased satisfaction. This may increase as general practitioners delegate more out of hours care to cooperatives and deputising services.
Department of General Practice and Primary Health Care, University of Leicester, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK. rkm@le.ac.uk
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McKinley
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Roberts
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004739:England; D005194:Family Practice / Q000592:standards*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009551:Night Care / Q000592:standards*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000592:standards*; D011787:Quality of Health Care / Q000145:classification*; D019037:Urban Health Services / Q000592:standards