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[Influence of the organizational model on user satisfaction]
A Delgado1, L A Lopez Fernández, J D Luna del Castillo
1Unidad Docente de Medicina de Familia y Comunitaria, Facultad de Medicina, Granada.
Objective:
To identify in Health Centres (HC), doctors' offices and out-patient clinics the variables among the use, the doctor and organisation, which most affect satisfaction of the Primary Care (PC) user.
Design:
A descriptive crossover study.
Setting:
PC level in three Andalusian cities.
Patients And Other Participants:
A sample of groups of 460 users of out-patient clinics and doctors' offices and 400 from HCs, all in an urban environment.
Measurements And Main Results:
Three questionnaires were used to gather the independent variables of organisation, doctor and use, and also the dependent variable, or satisfaction, in three dimensions: professional competence, personal qualities and accessibility. The reliability of the scale of satisfaction was analysed using Crombach's alpha; and discriminative capacity, using the Edwards test. The effect of the variables of doctor, user and organisation on HCs and doctors' offices / out-patient clinics was analysed separately with multiple regression. The determination coefficient of the variables for the user at doctors' offices / out-patient clinics was higher than the same variables in HCs (p < 0.0001), age being the variable which most affected satisfaction, both in HCs and doctors' offices / out-patient clinics. The determination coefficients for the regressions of the variables of doctor and organisation were higher in HCs than in doctors' offices / outpatient clinics (p < 0.001) in both cases - with the use of the clinical records being the primary variable in both organisations.
Conclusions:
It appears that the organisational model of HCs offers more possibilities of increasing user satisfaction by modifying determined features of the doctor and the organisation.