Healthy Communities: Coordination of health care – experiences with GP care among patients aged 45 and over, 2016 - Report - Care settings and patient-reported experiences of care

Healthy Communities: Coordination of health care – experiences with GP care among patients aged 45 and over, 2016

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Care settings and patient-reported experiences of care

Key findings

  • Almost 9 in 10 (87%) patients with both a usual GP or usual place of care felt that they received excellent or very good care in the previous year, compared with about 8 in 10 (81%) patients with a usual GP and about 6 in 10 (62%) patients with a usual place only.
  • In general, the best experiences of care were reported by patients with both a usual GP and place of care, followed by those with a usual GP only. The least positive experiences were reported by those with a usual place of care only.
  • Patient-reported experiences of care were similar across different care settings, including GP clinics, community health centres and Aboriginal Medical Services.
  • Better experiences of care were reported among patients who had been seeing their usual GP for longer periods of time. Around 9 in 10 patients (89%) who had been seeing their usual GP for 5 years or more felt that the care they received in the preceding 12 months was excellent or very good, compared with 3 in 4 (75%) patients who had been seeing their usual GP for less than 1 year.

For patients, the experience of continuity in primary care is the perception that GPs are aware of the patient’s health history, that their GP ‘knows them’ and that a provider who ‘knows them’ will care for them in the future (Haggerty et al. 2003). Having ongoing relationships (continuity) with a usual GP or usual place of care who ‘knows’ a patient facilitates patient-centred care; that is, care that accounts for patients’ needs, preferences, and the important role that patients and family members play as active participants in care (Singer et al. 2013).

This chapter presents information on patient-reported experience measures that fit into the dimension of patient-centred care (for example, whether or not patients were involved in decisions related to their care), by care setting. It examines whether GP care is perceived to be patient centred when patients see only a usual GP, visit a usual place of care (without a preference for a particular GP) or have both a usual GP and usual place of care.

A patient may refer to several different types of settings as their usual place of care—for example, a GP clinic, an Aboriginal Medical Service or a community health centre. As such, experiences of care across different place of care settings are also examined.

Note: These data are based on survey responses from adults aged 45 and over who had seen a GP in the 12 months before survey selection (November 2014 to November 2015), and who had visited a usual GP or usual place of care in the 12 months before completing the survey (April–June 2015 to April–June 2016).

Patient-reported experiences across care settings

In 2016, perceived experiences of patient-centred care varied by the type of care setting in which patients received care in the preceding 12 months. In general, patients felt that they received better experiences of care if they had both a usual GP and a usual place of care, compared with having either a usual GP or a usual place of care (Figure 4.1).

Figure 4.1: Patient-reported experience measures of care for patients aged 45 and over, by care setting, 2016

The following link expands the table data. Show tabular data Hide tabular data
Experience measures of care Usual GP and place Usual GP only Usual place only
% 95% CI % 95% CI % 95% CI
Care rated by patient as excellent or very good 87.0 (86.4 – 87.5) 80.8 (78.5 – 83.1) 62.3 (60.1 – 64.4)
Patient involved in decisions about their care 91.3 (90.8 – 91.8) 77.2 (75.4 – 79.0) 79.3 (78.0 – 80.6)
Patient was asked about work/life things that affect health 84.2 (83.6 – 84.8) 74.3 (72.7 – 75.9) 69.6 (66.5 – 72.6)
Test results were explained in a way that patient could understand 94.2 (94.0 – 94.5) 89.9 (88.0 – 91.8) 82.8 (80.8 – 84.8)
Comfortable talking about personal problems related to their health 83.6 (83.0 – 84.2) 83.3 (81.7 – 84.9) 60.0 (57.5 – 62.6)
95% confidence interval.
Note
These data are based on survey responses from adults aged 45 and over who had seen a GP in the 12 months before survey selection (November 2014 to November 2015), and who had visited a usual GP or usual place of care in the 12 months before completing the survey (April–June 2015 to April–June 2016).

How did patients rate the quality of care received?

Nationally, among the 80% of patients aged 45 and over who had both a usual GP and place of care, 87% felt that they received excellent or very good quality care in the previous year. Among the smaller proportion of patients who had a usual GP only, 81% felt they received excellent or very good quality care; this dropped to 62% among patients with only a usual place of care.

Did patients feel that were involved in decisions about their care?

Patients who had both a usual GP and place of care in the preceding year were most likely to feel that they were involved in decisions about their care (91%). Among the smaller proportion of patients who had either a usual GP or a usual place of care, about 4 in 5 (79%) of those who had a usual place of care only, and 77% of those who had a usual GP only, felt that they were involved in decisions about their care.

Were patients asked about things in their work or life that affect their health?

Over 8 in 10 (84%) patients who had both a usual GP and place of care in the preceding year felt that their usual GP or others in their usual place of care asked about things in their work or life that affect their health. This proportion was lower among patients who had a usual GP only (74%), and lower again among patients who had a usual place of care only (70%).

Were test results explained in a way that the patient could understand?

Among patients who had both a usual GP and place of care in the preceding year, 94% felt that test results were explained in a way that they could understand. Among those who had a usual GP only, 90% of patients felt that test results were explained in a way that they could understand, and this proportion decreased to 83% among those who had a usual place of care only.

Did patients feel comfortable discussing personal problems related to their health?

Similar proportions (84%) of patients who had a usual GP and place of care, or just a usual GP, reported that they felt comfortable discussing personal problems related to their health. A lower proportion (60%) of patients who had a usual place of care only reported that they felt comfortable discussing personal problems related to their health.

Usual place of care setting and patient-reported care experiences

In 2016, most patients who had a usual place of care went to a GP clinic with GPs only (53%) or a GP clinic with GPs and other health professionals (43%) for the majority of their GP care. A smaller proportion of patients visited a community health centre (2.0%), an Aboriginal Medical Service (0.3%), a hospital emergency department (1.2%), or somewhere else (0.5%) as their usual place of care.

Figure 4.2 presents variation in patient-reported experiences of care received across different care settings. In general, patient-reported experiences of care did not vary greatly across care settings, though there was some variation. For example, patients were more likely to feel that they received excellent or very good care in the preceding 12 months when their usual place of care was:

  • a clinic with GPs and other health professionals (86%)
  • an Aboriginal Medical Service (84%)
  • a GP clinic with GPs only (84%).

This proportion was lower among patients whose usual place of care was a community health centre (78%).

Analyses excluded patients who had a usual GP and a usual place of care, where their usual place of care was a hospital emergency department, as their reported primary care experiences may be more likely to relate to experiences with their usual GP than with their place of care setting (that is, care received in the hospital emergency department). Though the proportion of patients whose usual place of care was a hospital emergency department was small at a national level (1.2%), this proportion varied across PHN areas—increasing to 5.6% in the Western Queensland PHN area.

Figure 4.2: Patient-reported experiences of care, by usual place of care setting, 2016

The following link expands the table data. Show tabular data Hide tabular data
Experience measures of care Has usual place - clinic with GPs only Has usual place - clinic with GPs and other health professionals Has usual place - community health centre Has usual place - Aboriginal Medical Service Has no usual place, or usual place is unspecified
% 95% CI % 95% CI % 95% CI % 95% CI % 95% CI
Care rated by patient as excellent or very good 84.0 (83.0 – 85.1) 85.6 (84.6 – 86.5) 77.5 (72.4 – 82.6) 84.1 (79.1 – 89.0) 80.8 (78.5 – 83.1)
Patient involved in decisions about their care 90.1 (89.4 – 90.9) 90.7 (90.1 – 91.4) 81.3 (78.6 – 84.1) 87.0 (77.6 – 96.3) 77.2 (75.4 – 79.0)
Patient was asked about work/life things that affect health 81.7 (81.0 – 82.4) 84.3 (83.1 – 85.4) 74.8 (72.6 – 77.1) 88.7 (77.8 – 99.6) 74.3 (72.7 – 75.9)
Test results were explained in a way that patient could understand 92.8 (92.2 – 93.4) 94.0 (93.4 – 94.7) 91.2 (88.0 – 94.5) 90.5 (87.4 – 93.6) 89.9 (88.0 – 91.8)
Comfortable talking about personal problems related to their health 81.0 (79.8 – 82.2) 81.6 (80.5 – 82.7) 80.3 (76.2 – 84.4) 78.3 (74.8 – 81.7) 83.3 (81.7 – 84.9)
95% confidence interval.
Notes
  1. These data are based on Survey responses from adults aged 45 and over who had seen a GP in the 12 months before survey selection (November 2014 to November 2015), and who had visited a usual GP or usual place of care in the 12 months before completing the survey (April–June 2015 to April–June 2016).
  2. Due to the small number of patients included in survey with only a usual place of care and no usual GP, it is not possible to report care experiences of patients who did not have a usual GP and had a usual place of care only, by type of usual place of care. Information on care experiences presented in Figure 4.2 are experiences of those who had either a usual GP or place of care.

Length of patient-GP relationship and patient-reported care experiences

Patient responses from the survey showed a correlation between the duration of time over which a patient had visited a usual GP and better experiences of care (Figure 4.3). Compared with patients who had been seeing their usual GP for less than 1 year, patients who had been seeing their usual GP for 5 years or more were more likely to feel that they:

  • received excellent or very good care in the preceding year (89% compared with 75%)
  • were involved in decisions about their care (91% compared with 83%)
  • were asked about things in work or life that affect their health (85% compared with 77%)
  • had test results explained in a way that they could understand (95% compared with 87%)
  • were comfortable talking about personal problems related to their health (86% compared with 74%).

Figure 4.3: Selected patient-reported experiences of care, patients aged 45 and over, by length of time as patient of usual GP, 2016

The following link expands the table data. Show tabular data Hide tabular data
Experience measures of care Less than 1 year 1 year but less than 3 years 3 years but less than 5 years 5 years or more
% 95% CI % 95% CI % 95% CI % 95% CI
Care rated by patient as excellent or very good 75.1 (72.4 – 77.7) 81.6 (79.9 – 83.2) 85.0 (83.6 – 86.3) 89.0 (88.2 – 89.9)
Patient involved in decisions about their care 82.7 (80.6 – 84.8) 88.1 (86.8 – 89.3) 90.1 (89.7 – 90.5) 91.4 (90.6 – 92.3)
Patient was asked about work/life things that affect health 76.5 (74.3 – 78.6) 80.3 (78.9 – 81.7) 83.0 (81.9 – 84.1) 85.0 (84.3 – 85.6)
Test results were explained in a way that patient could understand 87.1 (85.6 – 88.7) 92.3 (91.4 – 93.3) 92.8 (91.7 – 93.9) 95.2 (94.6 – 95.8)
Comfortable talking about personal problems related to their health 73.7 (70.8 – 76.7) 77.9 (76.9 – 78.9) 80.9 (79.2 – 82.6) 86.4 (85.7 – 87.1)
95% confidence interval.
Note
These data are based on survey responses from adults aged 45 and over who had seen a GP in the 12 months before survey selection (November 2014 to November 2015), and who had visited a usual GP or usual place of care in the 12 months before completing the survey (April–June 2015 to April–June 2016).

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