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Rural - urban differences in determinants of patient satisfaction with primary care

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  • Weinhold, Ines
  • Gurtner, Sebastian

Abstract

In light of the rising regional inequalities in primary care provider supply, to ensure equitable access is a pressing issue in health policy. Most policy approaches fall short in considering the patient perspective when defining shortage areas. As a consequence, implementations of new service delivery models might fail to be responsive to patients' expectations. To explore regional differences in the relative importance of structure and process attributes as drivers of patient satisfaction with local primary care, we collected data from residents of three objectively well-supplied urban and six objectively worse-supplied rural areas in Germany and tested a multi-group structural equation model. The results suggest that the relative importance of care attributes is different among the regional conditions rural and urban. Regardless of regional constraints, the strongest determinants of satisfaction are not related to structural aspects but are concerned with the quality of the doctor-patient relationship. A lack of available choices and a higher tolerance in terms of distances provide possible explanations for the results. The high importance rural residents attribute to the interpersonal relation should not be neglected in the re-organization of traditional service delivery in rural areas.

Suggested Citation

  • Weinhold, Ines & Gurtner, Sebastian, 2018. "Rural - urban differences in determinants of patient satisfaction with primary care," Social Science & Medicine, Elsevier, vol. 212(C), pages 76-85.
    • Handle: RePEc:eee:socmed:v:212:y:2018:i:c:p:76-85
    DOI: 10.1016/j.socscimed.2018.06.019
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    1. Nemet, Gregory F. & Bailey, Adrian J., 2000. "Distance and health care utilization among the rural elderly," Social Science & Medicine, Elsevier, vol. 50(9), pages 1197-1208, May.
    2. Ernst Fehr & Klaus M. Schmidt, 1999. "A Theory of Fairness, Competition, and Cooperation," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 114(3), pages 817-868.
    3. Sitzia, John & Wood, Neil, 1997. "Patient satisfaction: A review of issues and concepts," Social Science & Medicine, Elsevier, vol. 45(12), pages 1829-1843, December.
    4. Foster, Michele M. & Earl, Peter E. & Haines, Terry P. & Mitchell, Geoffrey K., 2010. "Unravelling the concept of consumer preference: Implications for health policy and optimal planning in primary care," Health Policy, Elsevier, vol. 97(2-3), pages 105-112, October.
    5. Hart, L.G. & Larson, E.H. & Lishner, D.M., 2005. "Rural definitions for health policy and research," American Journal of Public Health, American Public Health Association, vol. 95(7), pages 1149-1155.
    6. Weinhold, Ines & Gurtner, Sebastian, 2014. "Understanding shortages of sufficient health care in rural areas," Health Policy, Elsevier, vol. 118(2), pages 201-214.
    7. Boerma, Wienke G. W. & Groenewegen, Peter P. & Van der Zee, Jouke, 1998. "General practice in urban and rural Europe: The range of curative services," Social Science & Medicine, Elsevier, vol. 47(4), pages 445-453, August.
    8. Annette Spellerberg & Denis Huschka & Roland Habich, 2007. "Quality of life in rural areas: processes of divergence and convergence," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 83(2), pages 283-307, September.
    9. Mead, Nicola & Bower, Peter, 2000. "Patient-centredness: a conceptual framework and review of the empirical literature," Social Science & Medicine, Elsevier, vol. 51(7), pages 1087-1110, October.
    10. Vogt, Verena & Siegel, Martin & Sundmacher, Leonie, 2014. "Examining regional variation in the use of cancer screening in Germany," Social Science & Medicine, Elsevier, vol. 110(C), pages 74-80.
    11. Campbell, S. M. & Roland, M. O. & Buetow, S. A., 2000. "Defining quality of care," Social Science & Medicine, Elsevier, vol. 51(11), pages 1611-1625, December.
    12. Panelli, Ruth & Gallagher, Lou & Kearns, Robin, 2006. "Access to rural health services: Research as community action and policy critique," Social Science & Medicine, Elsevier, vol. 62(5), pages 1103-1114, March.
    13. Robin Haynes & Andrew Lovett & Gisela Sünnenberg, 2003. "Potential Accessibility, Travel Time, and Consumer Choice: Geographical Variations in General Medical Practice Registrations in Eastern England," Environment and Planning A, , vol. 35(10), pages 1733-1750, October.
    14. Macintyre, Sally & Ellaway, Anne & Cummins, Steven, 2002. "Place effects on health: how can we conceptualise, operationalise and measure them?," Social Science & Medicine, Elsevier, vol. 55(1), pages 125-139, July.
    15. Ware, John E. & Snyder, Mary K. & Wright, W. Russell & Davies, Allyson R., 1983. "Defining and measuring patient satisfaction with medical care," Evaluation and Program Planning, Elsevier, vol. 6(3-4), pages 247-263, January.
    16. Ozegowski, Susanne & Sundmacher, Leonie, 2014. "Understanding the gap between need and utilization in outpatient care—The effect of supply-side determinants on regional inequities," Health Policy, Elsevier, vol. 114(1), pages 54-63.
    17. Hyndman, Jilda C. G. & Holman, C. D'Arcy J. & Pritchard, Douglas A., 2003. "The influence of attractiveness factors and distance to general practice surgeries by level of social disadvantage and global access in Perth, Western Australia," Social Science & Medicine, Elsevier, vol. 56(2), pages 387-403, January.
    18. Farmer, Jane & Kilpatrick, Sue, 2009. "Are rural health professionals also social entrepreneurs?," Social Science & Medicine, Elsevier, vol. 69(11), pages 1651-1658, December.
    19. Farmer, Jane & Lauder, William & Richards, Helen & Sharkey, Siobhan, 2003. "Dr. John has gone: assessing health professionals' contribution to remote rural community sustainability in the UK," Social Science & Medicine, Elsevier, vol. 57(4), pages 673-686, August.
    20. Ozegowski, Susanne & Sundmacher, Leonie, 2012. "Ensuring access to health care—Germany reforms supply structures to tackle inequalities," Health Policy, Elsevier, vol. 106(2), pages 105-109.
    21. Gurtner, Sebastian & Reinhardt, Ronny & Soyez, Katja, 2014. "Designing mobile business applications for different age groups," Technological Forecasting and Social Change, Elsevier, vol. 88(C), pages 177-188.
    22. Siegel, Martin & Koller, Daniela & Vogt, Verena & Sundmacher, Leonie, 2016. "Developing a composite index of spatial accessibility across different health care sectors: A German example," Health Policy, Elsevier, vol. 120(2), pages 205-212.
    23. Pascoe, Gregory C., 1983. "Patient satisfaction in primary health care: A literature review and analysis," Evaluation and Program Planning, Elsevier, vol. 6(3-4), pages 185-210, January.
    24. Buetow, Stephen A., 1995. "What do general practitioners and their patients want from general practice and are they receiving it? A framework," Social Science & Medicine, Elsevier, vol. 40(2), pages 213-221, January.
    25. Goddard, Maria & Smith, Peter, 2001. "Equity of access to health care services: : Theory and evidence from the UK," Social Science & Medicine, Elsevier, vol. 53(9), pages 1149-1162, November.
    26. Jody Hoffer Gittell, 2002. "Coordinating Mechanisms in Care Provider Groups: Relational Coordination as a Mediator and Input Uncertainty as a Moderator of Performance Effects," Management Science, INFORMS, vol. 48(11), pages 1408-1426, November.
    27. Culyer, A. J. & Wagstaff, Adam, 1993. "Equity and equality in health and health care," Journal of Health Economics, Elsevier, vol. 12(4), pages 431-457, December.
    28. Tutton, Richard, 2012. "Personalizing medicine: Futures present and past," Social Science & Medicine, Elsevier, vol. 75(10), pages 1721-1728.
    29. Wensing, Michel & Jung, Hans Peter & Mainz, Jan & Olesen, Frede & Grol, Richard, 1998. "A systematic review of the literature on patient priorities for general practice care. Part 1: Description of the research domain," Social Science & Medicine, Elsevier, vol. 47(10), pages 1573-1588, November.
    30. Lewis, J.Rees, 1994. "Patient views on quality care in general practice: Literature review," Social Science & Medicine, Elsevier, vol. 39(5), pages 655-670, September.
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    3. Baier, Natalie & Pieper, Jonas & Schweikart, Jürgen & Busse, Reinhard & Vogt, Verena, 2020. "Capturing modelled and perceived spatial access to ambulatory health care services in rural and urban areas in Germany," Social Science & Medicine, Elsevier, vol. 265(C).
    4. Weinhold, Ines & Wende, Danny & Schrey, Christopher & Militzer-Horstmann, Carsta & Schang, Laura & Sundmacher, Leonie, 2022. "Assessing patients’ acceptable and realised distances to determine accessibility standards for the size of catchment areas in outpatient care," Health Policy, Elsevier, vol. 126(11), pages 1180-1186.
    5. Jianqiang Xu & Juan Zheng & Lingzhong Xu & Hongtao Wu, 2021. "Equity of Health Services Utilisation and Expenditure among Urban and Rural Residents under Universal Health Coverage," IJERPH, MDPI, vol. 18(2), pages 1-15, January.

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