Satisfaction in Older Persons and General Practitioners during the Implementation of Integrated Care

• Published in: PloS one Vol. 11; no. 10; p. e0164536
• Main Authors: Poot, Antonius J, Caljouw, Monique A A, Waard, Claudia S de, Wind, Annet W, Gussekloo, Jacobijn
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 13.10.2016; Public Library of Science (PLoS)
• Subjects: Activities of daily living; Aged, 80 and over; Chi-square test; Chronic illnesses; Comparative analysis; Delivery of Health Care, Integrated - organization & administration; Drugs; Elderly; Evidence-based medicine; Female; General practitioners; General Practitioners - psychology; Health care policy; Homes for the Aged - organization & administration; Humans; Male; Medical care quality; Medical ethics; Medicine and Health Sciences; Older people; Organizational aspects; Patient Satisfaction - statistics & numerical data; Patients; People and Places; Personal Satisfaction; Physical Sciences; Physician-patient relations; Primary care; Public health; Research and Analysis Methods; Studies; Surveys and Questionnaires
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0164536

Integrated care for older persons with complex care needs is widely advocated. Particularly professionals and policy makers have positive expectations. Care outcome results are ambiguous. Receiver and provider satisfaction is relevant but still poorly understood. During implementation of integrated care in residential homes (The MOVIT project), we compared general satisfaction and satisfaction with specific aspects of General Practitioner (GP) care in older persons and GPs before (cohort I) and after at least 12 months of implementation (cohort II). The general satisfaction score for GP care given by older persons does not change (Cohort I (n = 762) mean score 8.0 (IQR:7.0-9.0) vs. Cohort II (n = 505) mean score 8.0 (IQR:7.0-8.0);P = 0.01). Expressions of general satisfaction in GPs do not show consistent change (Cohort I (n = 87) vs Cohort II (n = 66), percentage satisfied about; role as GP, 56% vs 67%;P = 0.194, ability to provide personal care, 60% vs 67%;P = 0.038, quality of care, 54% vs 62%;P = 0.316). Satisfaction in older persons about some specific aspects of care do show change; GP-patient relationship, points 61.6 vs 63.3;P = 0.001, willingness to talk about mistakes, score 3.47 vs 3.73;P = 0.001, information received about drugs, score 2.79 vs 2.46;P = 0.002. GPs also report changes in specific aspects: percentage satisfied about multidisciplinary meetings; occurrence, 21% vs 53%;P = <0.001, GP presence, 12% vs 41%;P = <0.001, and participation, 29% vs.51%;P = 0.046. General satisfaction about care received and provided shows no consistent change in older persons and GPs during the implementation of integrated care. Specific changes in satisfaction are found. These show an emphasis on inter-personal aspects in older persons and organizational aspects in GPs.