Is patient loyalty associated with quality of care? Results of a patient survey over primary care in Switzerland.

OBJECTIVE: The study aimed to evaluate quality of care and to determine which aspects are associated with the willingness to recommend the general practitioner (GP) as a part of patient loyalty. DESIGN: This was an exploratory study which collected patient data from ambulatory care in the German part of Switzerland between 2013 and 2016. SETTING: Primary care in Switzerland. PARTICIPANTS: Included patients from 79 primary care practices who volunteered to participate in the quality management system European Practice Assessment. Patients were afterwards asked to complete the European Task Force on Patient Evaluations of General Practice Care instrument. INTERVENTIONS: Describing influencing factors of quality of care on recommendation of the GP from the perspective of the patients. MAIN OUTCOME MEASURES: Patient perspective on quality of care. RESULTS: Survey respondent rate was 81.3%. Over 69% of the respondents were willing to recommend their GP. 'Listening to you' (94.2%) and 'interest in your personal situation' (93.0%) as a part of the domain 'relationship and communication' were rated as the highest quality criteria. The lowest rate was found for 'being able to speak to the GP on the telephone' (30.0%) and 'waiting time in the waiting room' (50.6%). Patient loyalty, in terms of willingness to recommend the GP, was strongly associated with most of the items under the 'relationship and communication' section but also with having more physician's assistants in the practice. CONCLUSIONS: The results are important for understanding patients' priorities with regard to general practice care. Patient assessment allows us to identify possible areas for quality improvement within the practice and could provide feedback.

Job satisfaction of primary care physicians in Switzerland: an observational study.

BACKGROUND: Job satisfaction of physicians is an important issue for performance of a health care system. The aim of the study was to evaluate the job satisfaction of primary care physicians in Switzerland and to explore associations between overall job satisfaction, individual characteristics and satisfaction with aspects of work within the practice separated by gender. METHODS: This cross-sectional study was based on a job satisfaction survey. Data were collected from 176 primary care physicians working in 91 primary care practices. Job satisfaction was measured with the 10-item Warr-Cook-Wall job satisfaction scale. Stepwise linear regression analysis was performed for physicians separated by gender. RESULTS: The response rate was 92.6%. Primary care physicians reported the highest level of satisfaction with 'freedom of working method' (mean = 6.45) and the lowest satisfaction for 'hours of work' (mean = 5.38) and 'income' (mean = 5.49). Moreover, some aspects of job satisfaction were rated higher by female physicians than male physicians. Within the stepwise regression analysis, the aspect 'opportunity to use abilities' (ß = 0.644) showed the highest association to overall job satisfaction for male physicians while for female physicians it was income (ß = 0.733). CONCLUSIONS: The presented results contribute to an understanding of factors that influence levels of satisfaction of female and male physicians. Therefore, research and intervention about job satisfaction should consider gender as well as the stereotypes that come along with these social roles.

Does a quality management system improve quality in primary care practices in Switzerland? A longitudinal study.

OBJECTIVES: To examine the effectiveness of the quality management programme--European Practice Assessment--in primary care in Switzerland. DESIGN: Longitudinal study with three points of measurement. SETTING: Primary care practices in Switzerland. PARTICIPANTS: In total, 45 of 91 primary care practices completed European Practice Assessment three times. OUTCOMES: The interval between each assessment was around 36 months. A variance analyses for repeated measurements were performed for all 129 quality indicators from the domains: 'infrastructure', 'information', 'finance', and 'quality and safety' to examine changes over time. RESULTS: Significant improvements were found in three of four domains: 'quality and safety' (F=22.81, p<0.01), 'information' (F=27.901, p<0.01) and 'finance' (F=4.073, p<0.02). The 129 quality indicators showed a significant improvement within the three points of measurement (F=33.864, p<0.01). CONCLUSIONS: The European Practice Assessment for primary care practices thus provides a functioning quality management programme, focusing on the sustainable improvement of structural and organisational aspects to promote high quality of primary care. The implementation of a quality management system which also includes a continuous improvement process would give added value to provide good care.