Service Production and Patient Satisfaction in Primary Care

Context: The institutional setting for the study was the primary physician service in Norway, where there is a regular general practitioner scheme. Each inhabitant has a statutory right to be registered with a regular general practitioner. There are large differences between physicians in service production. Objective: We studied whether difference in services production between physicians has an effect on how satisfied patients are with the services that are provided. Methodology: Data about patient satisfaction were obtained from a survey of a representative sample of the population. We obtained data about how satisfied the respondents were with waiting time to get an appointment and with two aspects of the quality of care they actually received: the amount of time the physician spent with them, and to what extent they perceived that the physician took their medical problems seriously. The survey data were merged with data on service production for the primary physician that the respondent was registered with. Service production was measured as the number of consultations per person on the list, and as the number of laboratory tests per consultation. Results: There was a positive and relatively strong association between the level of service production of the general practitioners and patient satisfaction with waiting time for a consultation. The association was weaker for satisfaction with the quality of care the respondents actually received. Conclusion: A high level of service production can be justified, since it increases patient satisfaction, particularly satisfaction with access to services.