Hospital based primary care clinics. Complementary to general practice

To describe the patients attending a hospital based primary care clinic (HBPCC) focusing on the main medical and non-medical reasons for their seeking health care at the clinic, and their expectations of, and satisfaction with the care.

The study was set in a HBPCC in the northern region of metropolitan Melbourne, Australia. Bilingual interviewers assisted consecutive new patients to complete a pre- and post-consultation questionnaire seeking information on the presenting complaint, patient-reported reason for encounter (RFE), doctor-recorded health problem, treatments received, and patient expectations of and satisfaction with care.

The sample (n = 197) was young (mean age 33 years). A high proportion came from a low socioeconomic group (68%) and there was a higher than expected proportion of patients with a non-English speaking background (NESB) (53%). Three-quarters had a regular GP elsewhere. Important reasons for choosing this service were accessibility and familiarity: being part of a hospital: case of obtaining radiological examinations, and the quality of the doctors. The commonest health problem was trauma related (14-16%). The main body systems involved were locomotor, skin, digestive, respiratory, pregnancy related and non specific. Patients were mostly satisfied with their cares those with ill-defined problems were more likely to report that their expectation were not completely met. There were no significant demographic and ethnic variations in the outcome variables.

HBPCCs can complement the GP's ongoing relationship with patients from NESB and lower socioeconomic groups to improve the continuity and coordination of healthcare. Experienced and culturally sensitive GPs, good communications, and an effective and comprehensive interpreter service are necessary to facilitate this care coordination. One strategy is a hospital based department of general practice linking academic GPs and a local divisional network of GPs, to provide this clinical service and undertake teaching and research in the areas highlighted by this study.