title: Effect of rurality on patients' satisfaction with out of hours care provided by a family doctor cooperative.
abstract: BACKGROUND
  Reacting to demand and supply pressures, European healthcare systems are undergoing significant structural changes to the organisation and delivery of out of hours care. Such pressures are of particular concern to rural practice. Although patient satisfaction with out of hours care has been extensively studied, the effect of rurality on satisfaction levels has not, to our knowledge, been previously examined.
  
  
  OBJECTIVE
  To investigate whether rurality has an influence on patient satisfaction with out of hours care provided by a family doctor co-operative.
  
  
  METHODS
  All patients contacting the service over a designated 24-day period were forwarded a postal questionnaire. Patients' satisfaction was measured using a version of the McKinley questionnaire, and rurality, by subjective patient assessment, distance from treatment centre or previous rota cover.
  
  
  RESULTS
  The response rate was 55% (531/966). Overall satisfaction levels were high with 88% of patients rating the service as either good or excellent. 47.8% of respondents perceived themselves as living in a town, 14.6% as living in a village, and 37.6% as living in the countryside. Perceived rurality, distance from treatment centre or previous rota cover did not significantly affect satisfaction levels.
  
  
  CONCLUSIONS
  Family doctor co-operatives have significantly altered the way out of hours care is delivered. Patients from rural areas are equally satisfied with the provision of out of hours care by co-operatives, as urban patients. Extension of co-operatives to rural areas need not be constrained by concerns regarding decreased patient satisfaction.
authors.affiliation: Clinical Science Institute, National University of Ireland, Galway, Ireland. lgglynn@eircom.net
authors.forename: L G
authors.initials: LG
authors.lastname: Glynn
authors.forename: M
authors.initials: M
authors.lastname: Byrne
authors.forename: A W
authors.initials: AW
authors.lastname: Murphy