title: A cross-sectional study of socio-demographic factors associated with patient access to primary care in Slovenia.
abstract: BACKGROUND
  Primary care (PC) is the provision of universally accessible, integrated, person-centred, comprehensive health and community services. Professionals active in primary care teams include family physicians and general practitioners (FP/GPs). There is concern in Slovenia that the current economic crisis might change the nature of PC services. Access, one of the most basic requirements of general practice, is universal in Slovenia, which is one of the smallest European countries; under national law, compulsory health insurance is mandatory for its citizens. Our study examined access to PC in Slovenia during a time of economic crisis as experienced and perceived by patients between 2011 and 2012, and investigated socio-demographic factors affecting access to PC in Slovenia.
  
  
  METHODS
  Data were collected as a part of a larger international study entitled Quality and Costs of Primary Care in Europe (QUALICOPC) that took place during a period of eight months in 2011 and 2012. 219 general practices were included; in each, the aim was to evaluate 10 patients. Dependent variables covered five aspects of access to PC: communicational, cultural, financial, geographical and organizational. 15 socio-demographic factors were investigated as independent variables. Descriptive statistics, factor analysis and multilevel analysis were applied.
  
  
  RESULTS
  There were 1,962 patients in the final sample, with a response rate of 89.6%. The factors with the most positive effect on access to PC were financial and cultural; the most negative effects were caused by organizational problems. Financial difficulties were not a significant socio-demographic factor. Greater frequency of visits improves patients' perception of communicational and cultural access. Deteriorating health conditions are expected to lower perceived geographical access. Patients born outside Slovenia perceived better organizational access than patients born in Slovenia.
  
  
  CONCLUSIONS
  Universal medical insurance in Slovenia protects most patients from PC inaccessibility. However, problems perceived by patients may indicate the need for changes in the organization of PC.
authors.affiliation: Department of Family Medicine, Ljubljana Medical School, Poljanski nasip 58, 1000, Ljubljana, Slovenia. suzana.kert@zd-mb.si.|Department of Family Medicine, Maribor Medical School, Maribor, Slovenia. suzana.kert@zd-mb.si.
authors.forename: Suzana
authors.initials: S
authors.lastname: Kert
authors.affiliation: Department of Family Medicine, Ljubljana Medical School, Poljanski nasip 58, 1000, Ljubljana, Slovenia. igor.svab@mf.uni-lj.si.
authors.forename: Igor
authors.initials: I
authors.lastname: Švab
authors.affiliation: Statistical Office of the Republic of Slovenia, Ljubljana, Slovenia. maja.sever1@gmail.com.
authors.forename: Maja
authors.initials: M
authors.lastname: Sever
authors.affiliation: Department of Family Medicine, Ljubljana Medical School, Poljanski nasip 58, 1000, Ljubljana, Slovenia. irena.makivic@mf.uni-lj.si.
authors.forename: Irena
authors.initials: I
authors.lastname: Makivić
authors.affiliation: Department of Family Medicine, Ljubljana Medical School, Poljanski nasip 58, 1000, Ljubljana, Slovenia. danica.rotar@gmail.com.
authors.forename: Danica Rotar
authors.initials: DR
authors.lastname: Pavlič
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*; D017524:Slovenia; D066252:Sociological Factors; D011795:Surveys and Questionnaires