• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of qualhcLink to Publisher's site
Qual Health Care. Jun 2001; 10(2): 90–95.
PMCID: PMC1757978

Age, gender, socioeconomic, and ethnic differences in patients' assessments of primary health care

Abstract

Background—Patients' evaluations are an important means of measuring aspects of primary care quality such as communication and interpersonal care. This study aims to examine variations in assessments of primary care according to age, gender, socioeconomic, and ethnicity variables.

Methods—A cross sectional survey of consecutive patients attending 55 inner London practices was performed over a 2 week period using the General Practice Assessment Survey (GPAS) instrument which assesses 13 important dimensions of primary care provision. Variations in scale scores were investigated for differences relating to age, gender, socioeconomic, and ethnic status as reported by respondents.

Results—A total of 7692 questionnaires were returned (71% response rate). Valid information on age, gender, socioeconomic status, and ethnicity was available for 4819 out of 5496 adult respondents. Approximately half the respondents reported their ethnic group as "white" and most of the remaining respondents reported belonging to "black" or South Asian groups. Significant differences existed between groups of patients defined by age or ethnicity for most of the scale scores examined. Black, South Asian, and Chinese respondents reported lower scores (representing less favourable assessments) than white respondents; older respondents reported more favourable evaluations of care than younger respondents; and less affluent groups reported lower scores than more affluent groups for two of the 13 dimensions. There was no significant difference between gender groups with respect to assessment of primary care. Age and ethnicity were independent predictors of respondents' assessments of primary care.

Conclusions—Differences exist between identifiable subgroups of the population in their assessments of primary health care measured using the GPAS instrument. This work adds to the literature on variation in healthcare experience and the potential for patient assessment of primary care. Further work is required to investigate these differences in more detail and to relate them to differences in the nature and process of primary care provision. Primary care providers need to ensure that services provided are appropriate for all patient groups within their communities.

Key Words: primary health care; ethnicity; inequality; quantitative methodology

Full Text

The Full Text of this article is available as a PDF (135K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Drever F, Whitehead M. Mortality in regions and local authority districts in the 1990s: exploring the relationship with deprivation. Popul Trends. 1995 Winter;(82):19–26. [PubMed]
  • Macintyre S, Hunt K, Sweeting H. Gender differences in health: are things really as simple as they seem? Soc Sci Med. 1996 Feb;42(4):617–624. [PubMed]
  • Emslie C, Hunt K, Macintyre S. Gender differences in minor morbidity among full time employees of a British university. J Epidemiol Community Health. 1999 Aug;53(8):465–475. [PMC free article] [PubMed]
  • Huff N, Macleod C, Ebdon D, Phillips D, Davies L, Nicholson A. Inequalities in mortality and illness in Trent NHS Region. J Public Health Med. 1999 Mar;21(1):81–87. [PubMed]
  • Vallance P, Martin J. Drug therapy for coronary heart disease: the Sheffield table. Lancet. 1997 Dec 20;350(9094):1854–1854. [PubMed]
  • Carr-Hill RA, Rice N, Roland M. Socioeconomic determinants of rates of consultation in general practice based on fourth national morbidity survey of general practices. BMJ. 1996 Apr 20;312(7037):1008–1012. [PMC free article] [PubMed]
  • Dicker A, Armstrong D. Patients' views of priority setting in health care: an interview survey in one practice. BMJ. 1995 Oct 28;311(7013):1137–1139. [PMC free article] [PubMed]
  • Wensing M, Jung HP, Mainz J, Olesen F, Grol R. A systematic review of the literature on patient priorities for general practice care. Part 1: Description of the research domain. Soc Sci Med. 1998 Nov;47(10):1573–1588. [PubMed]
  • Williams SJ, Calnan M. Key determinants of consumer satisfaction with general practice. Fam Pract. 1991 Sep;8(3):237–242. [PubMed]
  • Hall JA, Dornan MC. What patients like about their medical care and how often they are asked: a meta-analysis of the satisfaction literature. Soc Sci Med. 1988;27(9):935–939. [PubMed]
  • Ben-Sira Z. Lay evaluation of medical treatment and competence development of a model of the function of the physician's affective behavior. Soc Sci Med. 1982;16(9):1013–1019. [PubMed]
  • Roter DL, Hall JA. Physician's interviewing styles and medical information obtained from patients. J Gen Intern Med. 1987 Sep-Oct;2(5):325–329. [PubMed]
  • Donovan JL. Patient decision making. The missing ingredient in compliance research. Int J Technol Assess Health Care. 1995 Summer;11(3):443–455. [PubMed]
  • Ramsay J, Campbell JL, Schroter S, Green J, Roland M. The General Practice Assessment Survey (GPAS): tests of data quality and measurement properties. Fam Pract. 2000 Oct;17(5):372–379. [PubMed]
  • Wensing M, Grol R, van Montfort P, Smits A. Indicators of the quality of general practice care of patients with chronic illness: a step towards the real involvement of patients in the assessment of the quality of care. Qual Health Care. 1996 Jun;5(2):73–80. [PMC free article] [PubMed]
  • Macintyre S, Ellaway A, Der G, Ford G, Hunt K. Do housing tenure and car access predict health because they are simply markers of income or self esteem? A Scottish study. J Epidemiol Community Health. 1998 Oct;52(10):657–664. [PMC free article] [PubMed]
  • Phillips D, Brooks F. Age differences in women's verdicts on the quality of primary health care services. Br J Gen Pract. 1998 Apr;48(429):1151–1154. [PMC free article] [PubMed]
  • Baker R. Characteristics of practices, general practitioners and patients related to levels of patients' satisfaction with consultations. Br J Gen Pract. 1996 Oct;46(411):601–605. [PMC free article] [PubMed]
  • Curtis S, Lawson K. Gender, ethnicity and self-reported health: the case of African-Caribbean populations in London. Soc Sci Med. 2000 Feb;50(3):365–385. [PubMed]
  • Naish J, Brown J, Denton B. Intercultural consultations: investigation of factors that deter non-English speaking women from attending their general practitioners for cervical screening. BMJ. 1994 Oct 29;309(6962):1126–1128. [PMC free article] [PubMed]

Articles from Quality in Health Care : QHC are provided here courtesy of BMJ Group

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...