[How chronically ill patients evaluate their care: results of an evaluation study of the family doctor-centred health care model].
Considering the demographic development models for primary care have to be focused on chronic illness care especially. The so called "Hausarztzentrierte Versorgung" (HzV) in Baden-Wuerttemberg constitutes such a model of an implementation of family doctor-centred health care. For evaluation purposes the perspective of patients is of particular interest. Therefore the aim of this study was to analyse how chronically ill patients assess their medical care. Altogether 53 primary care practices in Baden-Wuerttemberg took part in a patient survey. The quality of chronic illness care from the patients' perspective was assessed by means of the PACIC short form. Furthermore the general satisfaction with care as well as sociodemographic characteristics were determined. For analysis two different groups were regarded: HzV-doctor and HzV-patient with a chronic condition (group 1) and non-HzV-doctor and non-HzV-patient with a chronic condition (group 2). Altogether 2,535 patients were recruited for the survey (response rate 47.8%). Out of these, 836 patients could be assigned to group 1 and 319 patients could be assigned to group 2. Patients in both groups were very satisfied with their care. The patients in group 1 stated more frequently that they received a written treatment plan from their general practitioner and that they were asked about their state of health when leaving the practice. Overall satisfaction was positively associated with organisation of care (β= 0.484), support in difficult situations (β= 0.171) and information on the usefulness of consulting other doctors (β= 0.163) with an explained variation of R(2)=0.459. Irrespective of their group affiliation patients rate the medical care of their chronic condition very positively. Especially the assessment of the quality of care from the perspective of different patient groups (HzV participants and non-HzV participants) could contribute essentially as a feedback for physicians concerning the implementation of the main contents of the HzV for participating physicians.
Abteilung Allgemeinmedizin und Versorgungsforschung, Universitätsklinikum Heidelberg. Electronic address: katja.goetz@med.uni-heidelberg.de.
Katja
K
Goetz
Joachim
J
Szecsenyi
Gunter
G
Laux
Stefanie
S
Joos
Martin
M
Beyer
Antje
A
Miksch
D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000523:psychology* / Q000628:therapy*; D005194:Family Practice / Q000458:organization & administration* / Q000592:standards*; D005260:Female; D005858:Germany; D006284:Health Plan Implementation / Q000458:organization & administration / Q000592:standards; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000458:organization & administration* / Q000592:standards*; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D018802:Patient-Centered Care / Q000458:organization & administration* / Q000592:standards*; D010817:Physician-Patient Relations; D011787:Quality of Health Care / Q000458:organization & administration* / Q000592:standards*; D012017:Referral and Consultation
Allgemeinmedizin; Chronische Krankheiten; Family practice; Hausarztzentrierte Versorgung; Versorgungsqualität; chronic disease; family doctor-centered care; quality of care