Perceived doctor-patient relationship and satisfaction with general practitioner care in older persons in residential homes

Abstract

Objective: Understanding patient satisfaction from the perspective of older adults is important to improve quality of their care. Since patient and care variables which can be influenced are of specific interest, this study examines the relation between patient satisfaction and the perceived doctor-patient relationship in older persons and their general practitioners (GPs).

Design: Cross-sectional survey.

Subjects and setting: Older persons (n = 653, median age 87 years; 69.4% female) living in 41 residential homes.

Main outcome measures: Patient satisfaction (report mark) and perceived doctor-patient relationship (Leiden Perioperative care Patient Satisfaction questionnaire); relationships were examined by comparing medians and use of regression models.

Results: The median satisfaction score was 8 (interquartile range 7.5–9; range 0–10) and doctor-patient relationship 65 (interquartile range 63–65; range 13–65). Higher satisfaction scores were related to higher scores on doctor-patient relationship (Jonckheere Terpstra test, p for trend <.001) independent of gender, age, duration of stay in the residential home, functional and clinical characteristics. Adjusted for these characteristics, per additional point for doctor-patient relationship, satisfaction increased with 0.103 points (β = 0.103, 95% CI 0.092–0.114; p < .001). In those with a ‘low’ doctor-patient relationship rating, the percentage awarding ‘sufficient or good’ to their GP for ‘understanding about the personal situation’ was 12%, ‘receiving attention as an individual’ 22%, treating the patient kindly 78%, and being polite 94%.

Conclusion: In older persons, perceived doctor-patient relationship and patient satisfaction are related, irrespective of patient characteristics. GPs may improve patient satisfaction by focusing more on the affective aspects of the doctor-patient relationship.

Key Points

• Examination of the perceived doctor-patient relationship as a variable might better accommodate patients’ expectations and improve satisfaction with the provided primary care.

Keywords:

• Doctor-patient relationship
• satisfaction
• general practitioner
• older persons
• residential home
• primary care

Acknowledgements

The authors thank the residential homes, the participants, the research nurses and all others involved in this study.

Ethical approval

The study was approved by the Medical Ethics Committee of the Leiden University Medical Center (P10.150) and registered at www.trialregister.nl (NTR2679).

Consent for publication

After informing resident committees and individual participants of the study and requesting participation by letter, oral consent was obtained by the research nurse after repeating the study information and procedures.

Disclosure statement

The authors declare that they have no competing interests.

Additional information

Funding

A grant was received from ZonMw, the Dutch Organisation for Health Research, the Netherlands (Project: 311060401).

Notes on contributors

Claudia S. de Waard

Claudia S de Waard, MSc, is the coordinator of the core training Geriatrics in Primary Care for general practitioners and elderly care physicians and researcher at the department of Public Health and Primary Care, Leiden University Medical Center, the Netherlands.

Antonius J. Poot

Antonius (Tony) J Poot, MD, is general practitioner, and advisor of the specialist trainings for general practitioners and elderly care physicians on the topic of inter-professional training in elderly care at the department of Public Health and Primary Care, Leiden University Medical Center, the Netherlands.

Wendy P. J. den Elzen

Wendy PJ den Elzen, PhD,is senior researcher at the department of Public Health and Primary Care, Leiden University Medical Center, the Netherlands.

Annet W. Wind

Annet W Wind, MD PhD, is general practitioner and head of the core training Geriatrics in Primary Care for general practitioners and elderly care physicians, at the department of Public Health and Primary Care, Leiden University Medical Center, the Netherlands.

Monique A. A. Caljouw

Monique AA Caljouw, PhD, is senior researcher and scientific coordinator of the University Network for the Care sector South Holland (UNC-ZH) at the department of Public Health and Primary Care, Leiden University Medical Center, the Netherlands.

Jacobijn Gussekloo

Jacobijn Gussekloo, MD PhD, is general practitioner, professor in primary careat the department of Public Health and Primary Care and director of the master program Vitality and Ageing at the department of Gerontology and Geriatrics , Leiden University Medical Center, the Netherlands.