Assessing the influence of socio‐demographic factors and health status on expression of satisfaction with GP services

Measures of patient satisfaction are used in the assessment of quality of healthcare, but the influence of patient‐based factors on reported satisfaction has been little described. This paper aims to quantify associations between reported satisfaction with GP services and measures of socio‐demographic and health status and the effect of adjusting for these factors in comparing satisfaction measured at the level of primary care organisations (PCOs).

Cross‐sectional analysis of the 1998 Welsh Health Survey, response rate 61 per cent. The 20,380 respondents, aged between 18 and 74 years reporting contact with their GP in the previous 12 months formed the study population. Satisfaction was defined as being “very” or “fairly satisfied” with GP services. Crude odds ratios were calculated(95 per cent confidence intervals) for reported satisfaction for the 22 PCOs in Wales and adjusted odds ratios were calculated for socio‐demographic variables and LLTI in logistic regression.

Satisfaction varied with age, gender, employment status, marital status, and reported LLTI. The rank order of reported satisfaction for PCOs changed by up to five places after adjusting for these factors.

The generalisability of this study should be assessed through further research on the impact of adjusting for patient based factors when using other validated measures of satisfaction.

Comparing measures of satisfaction between organisations to assess relative performance may not be valid unless differences in socio‐demographic composition are taken into account.

Highlights the importance of caution in using measures of patient satisfaction to assess performance.