Applying logistic regression analysis to identify patient’s satisfaction predictors with general practitioner assistance: evidence from four Italian regions.

Abstract

In the last years the interest for patient experience with health care services largely increased. Several surveys have been conducted in order to observe if health care systems answer to the overall patient needs. In 2000 World Health Organization challenged modern health care providers to ensure responsiveness to patients, i.e. to deliver also non-health assistance (respect for dignity, confidentiality, prompt attention, quality of amenities, access to social support networks, choice of provider, etc.). Poor evidence is available in Italy about connections between perceived quality and the capability of the healthcare system to respond to patients’ needs. This work aims at investigating patient experience with General Practitioner (GP) assistance and at measuring the impact of personal and organizational characteristics on overall satisfaction and on willingness to recommend. In 2009 a sample survey was conducted in four regions of Italy (Tuscany, Piedmont, Umbria, and Liguria). About 15.000 citizens answered to a large questionnaire related to Primary Care services, including a section dedicated to General Practitioner (GP) assistance. A logistic regression analysis was applied to analyze which are the predictors of overall satisfaction with GP, focusing mainly on variables related to patient’s expectations, continuity of care and organizational aspects (e.g. scheduled access, waiting time, health case history, etc.) and if there are differences across the four Italian Regions. Econometric analysis has been carried out through both ordered logistic regression and generalised ordered logit models. The inhabitants of the four Italian Regions refer a nice experience with GP assistance: more than 85% of them judged excellent or good the overall service. Generally, in some regions patient expectations affect more the willingness to recommend GP to friends or family members than the overall judgement on service. Besides, the findings provide convincing evidence that GP is a nodal point in the continuity of care process .: patient satisfaction, general practitioner, organizational aspects, continuity of care