1. PARTICIPANTS: o 174 of 1473 practices (12%) participated. o Returned questionnaires: o 1296 of 1556 (82.2%) patient experience questionnaires. o 155 of 174 (89.1%) patient values questionnaires. 1. VARIATION IN IDEAL EXPECTATIONS o Overall: Highest expectations: poor health (p=0.049), higher education (p=0.01) and older patients (p=0.11). o Age: Younger patients most valued: ‘ease of getting an appointment’. Older patients most valued: ‘ease of getting an appointment’ and ‘doctor knows important information about the patient’s background’. o Health: Patients in good health most valued: ‘doctor listens carefully to patients’, and ‘ease of getting an appointment’. Patients in poor health most valued: ‘ease of getting an appointment’ and ‘doctor knows important information about the patient’s background’. o Education: Lower educated patients most valued: ‘doctor involves patients in making decisions about treatment’. Higher educated patients most valued: ‘ease of getting an appointment’. o Least valued item for all groups: ‘doctor knows about the patient’s living situation’. 2. VARIATION IN EXPERIENCES o Overall: Best experience: older patients (p=0.02) and lower education (p=0.09). o Age: Older patients’ best experience: ‘staff at the reception are polite and helpful’. Younger patients’ best experience: ‘doctor is polite’ and ‘doctor listens carefully to patients’. o Health: Patients in good health best experience: ‘doctor is polite’. Patients in poor health best experience: ‘doctor is polite’, ‘doctor has patient’s medical records at hand’, and ‘staff at the reception are polite and helpful’. o Education: Best experience for both groups: ‘doctor is polite’. o Worst experience for all groups: ‘doctor knows about the patient’s living situation’. 3. DIFFERENCES IN THE EXTENT TO WHICH GROUPS’ PRIORITIES ARE BEING MET o Age: Younger patients: Concentrate here: ‘doctor has the patient’s medical records at hand’ and ‘doctor listens carefully to patients’. Possible overkill: ‘extensive opening hours’. Older patients: Maintain performance: ‘doctor has the patient’s medical records at hand’ and ‘doctor listens carefully to patients’. Low priority: ‘extensive opening hours’. o Health: Patients in good health: Concentrate here: ‘doctor has the patient’s medical records at hand’ and ‘doctor listens carefully to patients’. Possible overkill: ‘extensive opening hours’ and ‘proximity of practice’. Patients in poor health: Maintain performance: ‘doctor has the patient’s medical records at hand’, ‘doctor listens carefully to patients’ and ‘proximity of practice’. Low priority: ‘extensive opening hours’. o Education: Lower educated patients: Maintain performance: ‘doctor has the patient’s medical records at hand’, ‘doctor is polite’ and ‘doctor listens carefully to patients’. Low priority: ‘doctor asks patients about other possible problems besides the one s/he came for’ and ‘extensive opening hours’. Possible overkill: ‘short waiting time’. Higher educated patients: Concentrate here: ‘doctor has the patient’s medical records at hand’, ‘doctor is polite’, ‘doctor listens carefully to patients’ and ‘doctor asks patients about other possible problems besides the one s/he came for’. Possible overkill: ‘extensive opening hours’. Maintain performance: ‘short waiting time’. 4. IMPLICATIONS FOR INVESTMENT OF RESOURCES For all groups the areas needing the most improvement were: Patient knows how to get evening, night and weekend services. Ease of getting an appointment. After consulting the patients feel they can cope better with their health problem. Doctor involves patients in making treatment decisions. What patients value and what they experience in English general practice: comparison by patient characteristics Godoy Caballero, A 1., Sirdifield, C. 1, Siriwardena, A.N. 1, Windle, K. 1, Jackson, C. 1, McKay, S. 1, Schäfer, W. 2 1 University of Lincoln; 2 NIVEL, the Netherlands Institute for Health Services Research REFERENCES: 1. Campbell JL, Ramsay J, Green J. Age, gender, socioeconomic, and ethnic differences in patients' assessments of primary health care. Quality in health care : QHC. 2001;10(2):90-5. 2. Millar M. Patient satisfaction with general practice in Ireland. Irish medical journal. 2001;94(4):106, 8-9. 3. Sixma HJ, Spreeuwenberg PM, van der Pasch MA. Patient satisfaction with the general practitioner: a two-level analysis. Medical care. 1998;36(2):212-29. 4. Schäfer WL, Boerma WG, Kringos DS, De Maeseneer J, Gress S, Heinemann S, et al. QUALICOPC, a multi-country study evaluating quality, costs and equity in primary care. BMC family practice. 2011;12:115. 5. Hawes JM, Rao CP. Using importance-performance analysis to develop health care marketing strategies. Journal of health care marketing. 1985;5(4):19-25. Contact email: nsiriwardena@lincoln.ac.uknsiriwardena@lincoln.ac.uk Previous literature has pointed to a relationship between patient satisfaction and patient characteristics such as age, gender, health status, ethnicity and levels of education. Age: Older patients report higher satisfaction than younger patients. 1,2 Gender: Women express a lower satisfaction level than men for some attributes of care. 2 Other research has not found statistically significant differences by gender. 1 Level of education: Some evidence shows that dissatisfaction increases with the level of education 2. Evidence also shows a relationship between patient characteristics and satisfaction with individual dimensions of health care. Sixma et al. (1998) 3 explored the interaction between patient characteristics and three aspects of patient satisfaction: -Accessibility and availability of care vary by: age and health status. -Patients’ perceptions of GP’s humaneness varies by: age, self-reported psycho-social complaints and chronic diseases. -Patients’ perceptions of information giving by GP varies by: age, self-reported psycho-social complaints, chronic diseases and self-reported overall health. AIM: To investigate how patients’ satisfaction with primary care varied by personal characteristics using patient experience and values data from the QUALICOPC 4 study: 1.Do patients’ ideal expectations vary by age, health status and education? 2.Do patients’ experiences vary by patient characteristics? 3.Are there differences in the extent to which different groups’ priorities are being met in relation to what they experience? 4.Where should we invest resources to meet the needs of different patient groups? We used data from the patient experience and patient values QUALICOPC questionnaires to perform an Importance-Performance Analysis (IPA) combined with a diagonal model 5. Analyses were performed by the following patient characteristics: -Age: <65 vs. ≥ 65 years old. -Self-perceived health status: good health vs. poor health. -Level of education: no qualifications/GCSEs vs. post-GCSE. PERFORMANCE IMPORTANCE High Low CONCENTRATE HERE Attributes that patients value very highly but that currently receive low (poor) experience ratings after service users see their GP. Providers should concentrate on these attributes to optimise patients’ experiences of primary care services LOW PRIORITY Attributes that are relatively unimportant to patients, and also receive low (poor) experience ratings. From a patient perspective we should not concentrate on these attributes MAINTAIN PERFORMANCE Attributes are highly valued by patients, and patients report good experiences with regard to these attributes after they have seen their GP, so the performance should be kept as it is POSSIBLE OVERKILL Attributes that are rated as relatively unimportant to patients but nevertheless receive high (good) experience ratings. As these attributes are not that important, efforts could be made to use these “idle” resources in other aspects of health service Patients’ experiences and expectations of primary care varied according to characteristics such as age, perceived health status and education. Greater understanding of the expectations and experiences of different patient groups may help providers to tailor healthcare provision to different populations and, thereby, increase patient satisfaction with primary care. We also found that there were four items where provision could be improved to increase the satisfaction of all groups. Attributes used: 1. Doctor has the patient’s medical records at hand. 2. Doctor is polite. 3. Doctor listens carefully to patients. 4. Doctor takes sufficient time/doesn’t make the patient feel under pressure. 5. Doctor involves patients in making treatment decisions. 6. Doctor asks patients about other possible problems besides the one s/he came for. 7. Doctor knows important information about the patient’s background. 8. Doctor knows about the patient’s living situation. 9. After the visit the patient feels s/he can cope better with his/her health problem/illness. 10. Extensive opening hours. 11. Proximity of the practice to the patient’s house. 12. Short waiting time when contacting the practice. 13. The patient knows how to get evening, night and weekend services. 14. Reception staff are polite and helpful. 15. Ease of getting an appointment.