title: Delays in response and triage times reduce patient satisfaction and enablement after using out-of-hours services.
abstract: BACKGROUND
  several different models of out-of-hours primary care now exist in the UK. Important outcomes of care include users' satisfaction and enablement to manage their illness or condition, but the determinants of these outcomes in the unscheduled care domain are poorly understood. Aim. To identify predictors of user satisfaction and enablement across unscheduled care or GP out-of-hours service providers in Wales. The design of the study is a cross-sectional survey. The setting of the study is nine GP out-of-hours services, three Accident and Emergency units and an all Wales telephone advice service in Wales.
  
  
  METHODS
  postal survey using the Out-of-hours Patient Questionnaire. Logistic regression was used to fit both satisfaction and enablement models, based on demographic variables, service provider and treatment received and perceptions or ratings of the care process.
  
  
  RESULTS
  eight hundred and fifty-five of 3250 users responded (26% response rate, range across providers 14-41%, no evidence of non-response bias for age or gender). Treatment centre consultations were significantly associated with decreased patient satisfaction and decreased enablement compared with telephone advice. Delays in call answering or callback for triage and shorter consultations were significantly associated with lower satisfaction. Waiting more than a minute for initial call answering was associated with lower enablement.
  
  
  CONCLUSIONS
  giving users more time to discuss their illness in consultations may enhance satisfaction and enablement but this may be resource intensive. More simple interventions to improve access by quicker response and triage, and keeping users informed of waiting times, could also serve to increase satisfaction and ultimately impact on their enablement.
authors.affiliation: South East Wales Trials Unit, Department of Primary Care and Public Health, School of Medicine, Cardiff University, Second Floor, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS.
authors.forename: Mark
authors.initials: M
authors.lastname: Kelly
authors.forename: Jennifer N
authors.initials: JN
authors.lastname: Egbunike
authors.forename: Paul
authors.initials: P
authors.lastname: Kinnersley
authors.forename: Kerry
authors.initials: K
authors.lastname: Hood
authors.forename: Eleri
authors.initials: E
authors.lastname: Owen-Jones
authors.forename: Lori A
authors.initials: LA
authors.lastname: Button
authors.forename: Chris
authors.initials: C
authors.lastname: Shaw
authors.forename: Alison
authors.initials: A
authors.lastname: Porter
authors.forename: Helen
authors.initials: H
authors.lastname: Snooks
authors.forename: Sue
authors.initials: S
authors.lastname: Bowden
authors.forename: Adrian
authors.initials: A
authors.lastname: Edwards
mesh_terms: D000328:Adult; D039602:After-Hours Care / Q000379:methods / Q000592:standards*; D003430:Cross-Sectional Studies; D005260:Female; D006792:House Calls; D006801:Humans; D008297:Male; D009819:Office Visits; D010043:Outcome and Process Assessment, Health Care; D017060:Patient Satisfaction; D011209:Power, Psychological; D011320:Primary Health Care / Q000379:methods / Q000592:standards*; D011787:Quality of Health Care / Q000592:standards*; D011795:Surveys and Questionnaires; D013689:Telephone; D013997:Time Factors; D014218:Triage / Q000592:standards*; D014852:Wales