Evaluation of primary health services: the provider perspective

This study proposes a strategy for the evaluation of the quality of primary health services based on the provider's satisfaction with the service. In the area of health sciences only a few studies have inquired into the factors contributing to provider satisfaction. The present study tested the hypothesis that expectation regarding availability of services as well as the self-image as a provider of care and the assessment of a provider-patient relationship are major determinants of provider satisfaction. This hypothesis is derived from job satisfaction studies as well as from research on patient satisfaction. All general physicians, pediatricians, nurses, pharmacists and administrators working in 17 primary clinics in Israel were interviewed, in their clinics, by appointment (n = 147), using structured questionnaires which were especially designed for this study. Seventy-four percent of the team members stated that they were "satisfied" or "very satisfied" with the service they provide in the clinics. Overall satisfaction was significantly lower among doctors and pharmacists. The most important predictor of satisfaction is the assessment of adequacy of time devoted to patients. Only one third of the team members stated that the amount of time devoted for examination, treatment or conversation is as great as they would wish. The finding suggests that team members understand that the lack of availability of services and equipment, and lack of opportunities to meet with peers, as well as alien and cold relationships with patients, are all likely to bring about deterioration in their normative professional behavior.