title: Drivers of overall satisfaction with primary care: evidence from the English General Practice Patient Survey.
abstract: OBJECTIVE
  To determine which aspects of primary care matter most to patients, we aim to identify those aspects of patient experience that show the strongest relationship with overall satisfaction and examine the extent to which these relationships vary by socio-demographic and health characteristics.
  
  
  METHODS
  Data from the 2009/10 English General Practice Patient Survey including 2,169,718 respondents registered with 8362 primary care practices.
  Linear mixed-effects regression models (fixed effects adjusting for age, gender, ethnicity, deprivation, self-reported health, self-reported mental health condition and random practice effect) predicting overall satisfaction from six items covering four domains of care: access, helpfulness of receptionists, doctor communication and nurse communication. Additional models using interactions tested whether associations between patient experience and satisfaction varied by socio-demographic group.
  
  
  RESULTS
  Doctor communication showed the strongest relationship with overall satisfaction (standardized coefficient 0.48, 95% CI = 0.48, 0.48), followed by the helpfulness of reception staff (standardized coefficient 0.22, 95% CI = 0.22, 0.22). Among six measures of patient experience, obtaining appointments in advance showed the weakest relationship with overall satisfaction (standardized coefficient 0.06, 95% CI = 0.05, 0.06). Interactions showed statistically significant but small variation in the importance of drivers across different patient groups.
  
  
  CONCLUSIONS
  For all patient groups, communication with the doctor is the most important driver of overall satisfaction with primary care in England, along with the helpfulness of receptionists. In contrast, and despite being a policy priority for government, measures of access, including the ability to obtain appointments, were poorly related to overall satisfaction.
authors.affiliation: Cambridge Centre for Health Services Research, Institute of Public Health, University of Cambridge, Cambridge, UK.
authors.forename: Charlotte A M
authors.initials: CA
authors.lastname: Paddison
authors.affiliation: Cambridge Centre for Health Services Research, Institute of Public Health, University of Cambridge, Cambridge, UK.
authors.forename: Gary A
authors.initials: GA
authors.lastname: Abel
authors.affiliation: Cambridge Centre for Health Services Research, Institute of Public Health, University of Cambridge, Cambridge, UK.
authors.forename: Martin O
authors.initials: MO
authors.lastname: Roland
authors.affiliation: RAND Corporation, Santa Monica, CA, USA.
authors.forename: Marc N
authors.initials: MN
authors.lastname: Elliott
authors.affiliation: Cambridge Centre for Health Services Research, Institute of Public Health, University of Cambridge, Cambridge, UK.
authors.forename: Georgios
authors.initials: G
authors.lastname: Lyratzopoulos
authors.affiliation: University of Exeter Medical School, Smeall Building, Exeter, UK.
authors.forename: John L
authors.initials: JL
authors.lastname: Campbell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000458:organization & administration*; D012044:Regression Analysis; D012923:Social Class; D006113:United Kingdom; D055815:Young Adult
keywords: model; primary care; satisfaction; survey