When assessing the performance of general practices, it is better to ask patients about their actual experiences of care rather than ask for satisfaction ratings, according to new research published today (13 October 2010).
The findings have called into question the reliability of using surveys to evaluate GP practice performance.
Researchers from the University of Bristol set out to explore whether responses to survey questions reflect differences between the practices, the doctors, or the patients themselves.
Using mathematical models, they analysed data from 4,573 patients who consulted 150 different doctors at 27 general practices in England.
They found that specific questions about patients' experiences – particularly access to care – are a more accurate measure of practice and doctor performance than questions about patients' general satisfaction.
This is largely due to differences in people's perceptions as well as random error, and suggests that the reliability of using surveys to assess an individual doctor's performance is questionable, say the authors.
They also found that responses vary according to patient characteristics such as age, sex, and ethnicity. However, adjusting for these characteristics made very little difference to practices' scores or the ranking of individual practices.
In conclusion, they support the concept that questions about specific experiences of care provide a more discriminating measure of a practice's performance than do subjective questions about general satisfaction. And they call for their findings to be replicated in a larger sample of practices.
Your comments (terms and conditions apply):
"I think that patients have very strange ideas about what treatment etc they should receive, yes they still all want antibiotics if they sneeze twice! and the internet diagnoses are risible sometimes, unless patients are a lot more knowledgable their ability to judge is limited in clinical matters. In terms of general civility etc of staff they deal with that is very subjective and may reflect a patient's condition as much as their treatment though it is probably more reliable but again will tend to be viewed through last encounter, which may not be an accurate reflection of standards. Having seen the current survey I understand why many people give up before they reach the end and that is a negative against the Dr which is a nonsense, it is a negative against badly designed tedious repetitious highly anti GP skewed survey. In fact a waste of time and money that could be better spent elsewhere especially when some people – including a friend of mine – seem to get multiple copies!" – Name and address withheld