Good communication was valued as more important than accessibility according to 707 Nordic primary care patients: a report from the QUALICOPC study

OBJECTIVE: To explore Nordic patients’ ranking of the importance of different aspects of general practice. DESIGN: Patients ranked the importance of 47 statements reflecting five quality domains: communication, involvement, accessibility, continuity, and comprehensiveness. SETTING: Nordic general practice. SUBJECTS: Patients ≥18 years in general practitioners waiting rooms. MAIN OUTCOME MEASURES: Items rated as important or very important by ≥ 90% in all countries were identified. Associations with patient characteristics were analysed by logistic regression. RESULTS: 209 Danish, 175 Norwegian, 129 Finnish, 112 Swedish and 82 Icelandic patients responded. Ten statements were ranked as important or very important by ≥90% in each country. Six pertained to communication, three to patient involvement and one to the comprehensiveness of care. No items regarding accessibility or continuity exceeded the 90% limit. The item most frequently rated as very important was ‘I understand what the GP explains’’. Female patients were more likely to value personal treatment (OR = 2.9; 95%CI 1.5–5.5) and receiving instructions if things went wrong (1.7; 1.2–2.2). Older patients >65 years put less emphasis than those <35 on whether the GP takes them seriously (0.4; 0.3–0.5) and on the importance of instructions (0.5; 0.4–0.7). Patients with chronic diseases were less concerned (0.6; 0.4–0.8) with receiving instructions, but valued strongly that a GP knows when to refer (2.2; 1.5–3.3). CONCLUSION: Patients in all countries assigned high value to good communication. Availability was deemed important but came secondary to good communication. IMPLICATIONS: Organisational framework for general practice must allow for acceptable communication quality as well as availability. KEY POINTS: In order to identify relevant service areas for quality improvement in primary care, we aimed to increase knowledge of patient ranked importance of different dimensions of care. Nordic primary care patients valued good communication and involvement in decisions higher than accessibility to care. A singular focus on the access of care when developing services may not be in accordance with patient preferences.