[The opinion of the users as opportunity for improvement in primary health care].
OBJECTIVE
To determine those aspects of Primary Care Center (PCC) that displeases more the clients/users, to investigate its determinants, and to apply the intervention or corresponding interventions.


METHODS
Results evaluation oriented. Detection of dissatisfaction reasons through cross observational study from survey self-fulfilled on 200 individuals selected through random cluster sampling. A continuous improvement group was implemented in order to the factors causing detected problems and their possible solutions were analyzed.


METHODS
Rambla PCC, Sant Feliu de Llobregat. Catalonian Health Institute.


METHODS
Users/clients of the PCC who were in the waiting room. Improvement Group: Professionals of Sant Feliu Primary Care Team and Baix Llobregat Nord Primary Care Service.


METHODS
Reorganization of the family doctors' agendas and reduction of bureaucratic tasks in the physicians' offices.


METHODS
Respondents socio-demographic data, and reasons for their dissatisfaction. Determinants of the problem were analyzed. The principal cause of discomfort was the delay of previous appointment.


RESULTS
Among reasons for discomfort expressed by the users, the most frequent was lag time with 16% (95% CI, 10.9-21.1). This complaint referred both to wait for obtaining visit and to be in the waiting room before being visited. As determinants of delay there were identified a high number of patients, visits duplicity, bureaucratic visits, high number of urgent visits and an insufficient previous appointment visits.


CONCLUSIONS
Patient's opinions help us to know how public health services are accomplishing their expectations. Process improvement is indispensable in order to provide a quality product, but it must be endowed with resources adequacy to population needs.
Nebot Adell
C
C
Servicio de Atención Primaria Baix Llobregat Nord, Instituto Catalán de la Salud, Barcelona, Spain. nebotcar@paho.org
Baqués Cavallé
T
T
Crespo García
A
A
Valverde Caballero
I
I
Canela-Soler
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011320:Primary Health Care / Q000592:standards*; D011787:Quality of Health Care; D012494:Sampling Studies; D012959:Socioeconomic Factors; D013030:Spain; D011795:Surveys and Questionnaires