[Perceptions and expectations on primary health care: a new form of identifying improvements in the care system]

To analyse the opinions of the users of primary care on the care that they receive and to identify the principal areas of satisfaction.

Qualitative study using discussion groups and open interviews during the period January-May 2003.

Health areas of Valladolid, Spain.

The inclusion criteria were: to have attended a primary care clinic at sometime and to be between 35 and 80 years old. Recruitment was carried out through key informants, using the snowball technique.

6 discussion groups and interviews with representatives of 3 nursing and 1 residents association were carried out. Structural sampling was carried out as regards the variables that influenced satisfaction. The conversations were recorded using tape recorders and literally transcribed on paper. The analysis of the texts was carried out by 2 investigators and concordance was sought between them.

The principal areas related to satisfaction were: the treatment received from the professionals, which is considered a fundamental part of care, combined with the technical quality, continuity of the care, the admission services, the bureaucratic procedures, the barriers for accessing specialised services, and waiting lists.

Personalized care, the time dedicated by the professional, the continuity of care, and waiting lists are the principal areas related to the perceived satisfaction of the patients. The possible responses to improve this situation are: the implementation of changes in the care management and organisation which would simplify the procedures, investment of resources (human and economic), changes in the model of the professional-patient relationship, and improvements in undergraduate and postgraduate training.