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Associations between primary care practice type and patient-reported access.

K Selby1, J-C Zuchuat2, C Cohidon3

  • 1Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland. kevin.selby@hospvd.ch.

BMC Health Services Research
|October 18, 2018
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Summary

Primary care practices offering more services saw fewer patients postpone necessary visits. However, overall patient access to Swiss primary care showed limited association with practice comprehensiveness.

Keywords:
AccessComprehensivenessPrimary careSwitzerland

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Area of Science:

  • Healthcare Services Research
  • Primary Care Medicine
  • Health Services Accessibility

Background:

  • A global typology of Swiss primary care (PC) was previously established using latent variables.
  • This study investigates the relationship between service comprehensiveness and patient-perceived access in Swiss PC.

Purpose of the Study:

  • To explore associations between the comprehensiveness of services offered by primary care practices and patient-perceived access.
  • To determine if practice type influences patient experiences with appointment availability, opening hours, and visit postponements.

Main Methods:

  • Cross-sectional surveys of physicians (Swiss PC Active Monitoring network) and their patients.
  • Multivariate, multilevel analyses assessed associations between practice comprehensiveness scores and patient-reported access outcomes.
  • Patient outcomes included ease of getting appointments, restricted opening hours, and postponed/abstained visits.

Main Results:

  • Greater service comprehensiveness was linked to fewer patients postponing necessary visits (OR 0.93, p=0.03).
  • No significant association was found between service comprehensiveness and difficulty obtaining appointments.
  • A weak association between higher comprehensiveness and restricted opening hours was observed but not consistently significant.

Conclusions:

  • While comprehensive primary care services may reduce visit postponements, evidence linking practice typology to overall patient-reported access is limited.
  • Further research is needed to fully understand the complex interplay between primary care organization and patient access.