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Patients' perceptions of health system responsiveness in ambulatory care in Germany.

Autor
Tille F, Röttger J, Gibis B, Busse R, Kuhlmey A, Schnitzer S
Journal
PEC - Patient Education and Counseling, Volume 102, Issue 1, January 2019, Pages 162-171
doi.org/10.1016/j.pec.2018.08.020

Abstract

Objective

To identify overall levels of health system responsiveness and the associations with social determinants for ambulatory health care in Germany from a user perspective.

Methods

This analysis drew on a 2016 health survey sample of 6113 adults in Germany. Responsiveness was measured for general practitioners (GPs) and specialists (SPs) along the domains trust, dignity, confidentiality, autonomy and communication. Bivariate and multivariate logistic regression techniques were applied.

Results

Over 90% of all patients assessed their last GP and SP visit as good regarding trust, dignity, autonomy and communication, but only half for confidentiality in the doctor office (GP visits: 50.3%; SP visits: 52.4%). For GP visits, patients’ young age of 18–34 years showed most associations with poor assessment of the domains, for SP visits a current health problem as the reason for the last consultation.

Conclusion

While overall responsiveness levels for ambulatory care are high, ratings of confidentiality are distressing. Particularly patients’ young age and bad health are associated with a poor assessment of responsiveness.

Practice implications

Measures to improve doctor office infrastructure and to enhance responsiveness towards patients under the age of 35 years and those with health problems are vital to increase responsiveness.

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