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Original article

Vol. 145 No. 0304 (2015)

Older persons’ perceptions of general practitioner or specialist primary care physicians: same point of view?

  • Matthieu Sauter
  • Brigitte Santos-Eggimann
  • Jacques Spagnoli
DOI
https://doi.org/10.4414/smw.2015.14085
Cite this as:
Swiss Med Wkly. 2015;145:w14085
Published
11.01.2015

Summary

BACKGROUND: Identification of a Primary Care Physician (PCP) by older patients is considered as essential for the coordination of care, but the extent to which identified PCPs are general practitioners or specialists is unknown. This study described older patients’ experiences with their PCP and tested the hypothesis of differences between patients who identify a specialist as their PCP (SP PCP) and those who turn to a general practitioner (GP PCP).

METHODS: In 2012, a cross-sectional postal survey on care was conducted in the 68+ year old population of the canton of Vaud. Data was provided by 2,276 participants in the ongoing Lausanne cohort 65+ (Lc65+), a study of those born between 1934 and 1943, and by 998 persons from an additional sample drawn to include the population outside of Lausanne or born before 1934.

RESULTS: Participants expressed favourable perceptions, at rates exceeding 75% for most items. However, only 38% to 51% responded positively for out-of-hours availability, easy access and at home visits, likelihood of prescribing expensive medication if needed, and doctors’ awareness of over-the-counter drugs. 12.0% had an SP PCP, in 95.9% specialised in a discipline implying training in internal medicine. Bivariate and multivariate analyses did not result in significant differences between GP and SP PCPs regarding perceptions of accessibility/availability, doctor-patient relationship, information and continuity of care, prevention, spontaneous use of the emergency department or ambulatory care utilisation.

CONCLUSIONS: Experiences of old patients were mostly positive despite some lack in reported hearing, memory testing, and colorectal cancer screening. We found no differences between GP and SP PCP groups.

References

  1. Hall JA, Dornan MC. What patients like about their medical care and how often they are asked – a meta-analysis of the satisfaction literature. Social science & medicine. 1988;27(9):935–9.
  2. Vuori H. Patient satisfaction – does it matter? Quality assurance in health care: the official journal of the International Society for Quality Assurance in Health Care / ISQA. 1991;3(3):183–9.
  3. Williams B. Patient satisfaction – a valid concept. Social science & medicine. 1994;38(4):509–16.
  4. Crossing the Quality Chasm: A New Health System for the Twenty-first Century. Washington DC: Institue of Medicine; 2001.
  5. DiMatteo MR. Enhancing patient adherence to medical recommendations. JAMA: the journal of the American Medical Association. 1994;271(1):79, 83.
  6. Safran DG, Taira DA, Rogers WH, Kosinski M, Ware JE, Tarlov AR. Linking primary care performance to outcomes of care. J Fam Pract. 1998;47(3):213–20.
  7. DiMatteo MR, Giordani PJ, Lepper HS, Croghan TW. Patient adherence and medical treatment outcomes – A meta-analysis. Medical Care. 2002;40(9):794–811.
  8. Browne K, Roseman D, Shaller D, Edgman-Levitan S. Measuring Patient Experience As A Strategy For Improving Primary Care. Health Aff. 2010;29(5):921–5.
  9. Forgan Morle KM. Patient satisfaction: care of the elderly. J Adv Nurs. 1984;9(1):71–6.
  10. Kong MC, Camacho FT, Feldman SR, Anderson RT, Balkrishnan R. Correlates of patient satisfaction with physician visit: differences between elderly and non-elderly survey respondents. Health Qual Life Outcomes. 2007;5:62.
  11. O’Leary A. Patient satisfaction as a measure of quality in the care of the elderly. Br J Nurs. 1992;1(9):470–2.
  12. Owens DJ, Batchelor C. Patient satisfaction and the elderly. Social science & medicine. 1996;42(11):1483–91.
  13. Callahan EJ, Bertakis KD, Azari R, Robbins JA, Helms LJ, Chang DW. The influence of patient age on primary care resident physician-patient interaction. Journal of the American Geriatrics Society. 2000 Jan;48(1):30–5.
  14. Office fédéral de la statistique suisse N. Scenarios de l'évolution de la population des cantons 2010–2035 Neuchâtel 2011.
  15. Office fédéral de la statistique suisse N. Enquête suisse sur la santé. In: Office fédéral de la statistique suisse N, ed. Neuchâtel: Office fédéral de la statistique suisse 2007:7.
  16. Hashem A, Chi MTH, Friedman CP. Medical errors as a result of specialization. J Biomed Inform. 2003;36(1–2):61–9.
  17. Santos-Eggimann B, Karmaniola A, Seematter-Bagnoud L, Spagnoli J, Bula C, Cornuz J, et al. The Lausanne cohort Lc65+: a population-based prospective study of the manifestations, determinants and outcomes of frailty. BMC geriatrics. 2008;8:20.
  18. Lc65+. [Internet] [updated 2011 Nov cited 2013 May 24] Available from: www.lc65plus.ch/en/lc65_home/lc65–methodologie/lc65–echantillonnage.htm http://www.lc65plus.ch/en/
  19. FMH – ISFM. [Internet] [cited 2013 Mar 15] Available from: http://www.fmh.ch/fr/formation-isfm/formation_postgraduee/programmes_formation_postgr.html
  20. USPSTF. United State Preventive Services Task Force. [internet] [cited 2013 Mar 15] Available from: http://www.uspreventiveservicestaskforce.org
  21. Cornuz J, Guessous I, Rodondi N. Primary prevention and screening in adults: update 2006. Rev Med Suisse. 2006;2(50):262–73.
  22. Deriaz S, Bridel Grosvernier L, Tissot JD. Being a doctor: the influence of gender on the career choices and prospects. Rev Med Suisse. 2010;6(257):1438–42.
  23. Office fédéral de la statistique suisse N. Déterminants et évolution des coûts du système de santé en Suisse – Revue de la litterature et projections à l'horizon 2030. In: Office fédéral de la statistique suisse N, ed. 2007.
  24. Naim ROH, Escher M. Self medication with analgesics: what are the risks? Rev Med Suisse. 2010;6(255):1338–41.
  25. Orriols L, Gaillard J, Lapeyre-Mestre M, Roussin A. Evaluation of Abuse and Dependence on Drugs Used for Self-Medication A Pharmacoepidemiological Pilot Study Based on Community Pharmacies in France. Drug Saf. 2009;32(10):859–73.
  26. AESGP. European medication market data. [Internet] [cited 2013 May 27] Available from: http://www.aesgp.eu/facts-figures/market-data/#pharma
  27. Shield B. Evaluation of the social and economic costs of hearing impairment; 2006.
  28. Kraft E, Marti M, Werner S, Sommer H. Cost of dementia in Switzerland. Swiss Med Wkly. 2010;140.
  29. Joseph DA, King JB, Miller JW, Richardson LC, Centers for Disease C, Prevention. Prevalence of colorectal cancer screening among adults – Behavioral Risk Factor Surveillance System, United States, 2010. MMWR Morbidity and mortality weekly report. 2012;61(Suppl):51–6.