Patient involvement in assessing consultation quality: a quantitative study of the Patient Enablement Instrument in Poland.
BACKGROUND
Promoting a more patient-responsive service has been the focus of policy initiatives in newer EU states. One measure of success should be the patient's assessment of their consultation with their doctor.


OBJECTIVE
To measure consultation quality in Polish primary care using patient enablement (a patient-driven instrument developed in the UK) and to test its theoretical framework. To compare the patient enablement outcome of different types of doctor delivering primary care in Poland following reform.


METHODS
Cross-sectional quantitative questionnaire survey.


METHODS
Random sample of primary care doctors practising within a 60-km radius of Gdansk, Poland.


METHODS
Patient Enablement Instrument and correlates were measured in 7924 consecutive adult consultations of 48 doctors, stratified according to training: family medicine specialists (diploma holders), non-diplomates and general medicine doctors (polyclinic internists).


RESULTS
Completion was high (78%). The mean patient enablement score in Poland was 4.0 (SD 3.3) and mean consultation length was 10.3 min (SD 5.4 min). Consultation length and knowing the doctor are independently related to patient enablement in the Polish context. Variation between doctors is significant, but earlier differences in enablement between alternative providers have largely been ameliorated in practice.


CONCLUSIONS
It is feasible to use patient enablement on a large scale at routine consultation in primary care in Poland: acceptability was good in diverse environments. The internal consistency of enablement and its relationships broadly mirror those found in the UK. The effect of patient expectations shaped by social and cultural issues influencing enablement outcome requires further investigation.
Pawlikowska
Teresa R B
TR
Associate Clinical Professor, Warwick Medical School, The University of Warwick, Coventry, UK. Teresa.Pawlikowska@warwick.ac.uk
Walker
Jeremy J
JJ
Nowak
Pawel R
PR
Szumilo-Grzesik
Wieslawa
W
D003430:Cross-Sectional Studies; D005260:Female; D018166:Health Care Reform; D006801:Humans; D008297:Male; D010358:Patient Participation; D017060:Patient Satisfaction; D011044:Poland; D012017:Referral and Consultation / Q000592:standards*