title: Decreasing trends in patient satisfaction, accessibility and continuity of care in Finnish primary health care - a 14-year follow-up questionnaire study.
abstract: BACKGROUND
  The aim here was to explore trends in patient satisfaction with primary health care and its accessibility and continuity, and to explore whether through reforms and improvements some of the essential goals had been achieved over a 14-year period of time in Finland.
  
  
  METHODS
  Nine questionnaire surveys were conducted over a period of 14 years among patients attending within one week in the 65 health centres in the Tampere University Hospital catchment area. A total of 147,394 responded out of a sample of 333,648 patients. The response rate varied yearly from 53% to 37%.
  
  
  RESULTS
  Patient satisfaction with care in Finnish health centres decreased by nearly 9 percentage units from 1998 to 2011. The fall-off was most marked in the age-group over 64 years. There was a 20 percentage unit's reduction in ease of access as reported by patients. Respondents also reported that the continuity of care had deteriorated.
  
  
  CONCLUSIONS
  Despite major reforms in Finnish health care policy, patients seem to be less satisfied. Our findings challenge both Finnish authorities and GPs to improve the accessibility and continuity of care in primary health services.
authors.affiliation: Primary Care Unit, Joint Authority for Päijät-Häme Social and Health Care Group, Keskussairaalankatu 7, FI-15850 Lahti, Finland. risto.raivio@phsotey.fi.
authors.forename: Risto
authors.initials: R
authors.lastname: Raivio
authors.forename: Juhani
authors.initials: J
authors.lastname: Jääskeläinen
authors.forename: Doris
authors.initials: D
authors.lastname: Holmberg-Marttila
authors.forename: Kari J
authors.initials: KJ
authors.lastname: Mattila
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003266:Continuity of Patient Care / Q000639:trends*; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006297:Health Services Accessibility / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000639:trends*; D011795:Surveys and Questionnaires