Patient enablement after a consultation with a general practitioner-Explaining variation between countries, practices...

Area of Science:

• Primary Health Care Research
• Health Services Research
• Cross-cultural Health Studies

Background:

• Patient enablement is a crucial metric for assessing primary health care quality.
• A significant gap exists in the international comparative analysis of patient enablement.

Purpose of the Study:

• To elucidate the factors contributing to variations in patient enablement among patients, general practitioners (GPs), and across different countries.
• To identify independent variables associated with patient enablement.

Main Methods:

• Multi-level logistic regression models were employed, incorporating patient, GP, and country-level variables.
• Data were sourced from the Quality and Costs of Primary Care in Europe (QUALICOPC) study, complemented by PHAMEU data and Hofstede's cultural dimensions.
• Analysis included calculating explained variances at each level and odds ratios for independent variables.

Main Results:

• Patient and country-level factors explained substantial variance in patient enablement (50.6% country, 18.4% practice).
• National cultural dimensions were major drivers of inter-country variation.
• Patient characteristics and perceptions of consultations showed the strongest associations with enablement, while healthcare system structures did not.

Conclusions:

• Significant international disparities in patient enablement exist, influenced by patient attributes and cultural contexts.
• Patient-reported outcomes require careful interpretation considering cultural influences when evaluating healthcare system performance.