Rural residents happier with their GP service than those in urban areas

Rural residents are happier with their GP service than those in urban areas, research from the University of Aberdeen has revealed.

The study examined responses to a patient satisfaction survey from 766 practices across the country, specifically regarding patient experiences in relation to patient-centred care and continuity of care.

Patients in the most rural/remote practices were significantly more satisfied for all questions analysed.

Patients were asked to indicate their level of agreement with a number of statements, such as ‘I was listened to’, ‘I was given enough time’, ‘I was treated with compassion and understanding’, ‘I was given the opportunity to involve the people that matter to me’, ‘I understood the information I was given’, ‘I was in control of my treatment/care’, ‘I knew the healthcare professional well’, and ‘my treatment/care was well coordinated’.

GP services in urban and rural areas differ in several important ways - patients attending rural and remote practices are, for example, likely to be served by a smaller clinical team that provides a greater range of clinical services than urban practices, which are more likely to be located close to hospitals.

The researchers analysed results of the Health and Care Experience (HACE) survey and the study aimed to find out if there were trends in the differences between patient experiences across Scotland.

The HACE survey, which began in 2009 and has been carried out every two years, is sent to a random sample of patients registered with a GP in Scotland, and asks about personal experiences of GP practice, out of hours health care, care, support and help with everyday living and caring responsibilities. It aims to provide local and national information on the quality of health and care services from the perspective of users.

Published in Rural and Remote Health the findings showed patients in the most rural/remote practices were significantly more satisfied for all questions analysed

Average response rates to the survey were also higher in the most remote areas.

In the most recent HACE survey, 2017/18, there was a 22% response rate overall in Scotland. The response rate ranged from 18% of people living in large urban areas to 31% of people living in remote rural areas.

Isha Iqbal, from the University of Aberdeen and co-first author of the research, said: “The findings show that while Scottish patients generally have high levels of satisfaction when seeing a GP, those living in more remote rural areas are most satisfied, while those residing in suburban and small-town areas were least satisfied.

“This research is important because recruitment to rural general practice has always been difficult, and this study demonstrates that rural patients are particularly likely to appreciate the comprehensive care that their GP offers.”

Miss Iqbal added: “Additionally the study provides some evidence that personal continuity of care, which is under threat in general practices in some areas, is greatly appreciated by patients and is more likely to be achieved in rural and remote areas.

“However further studies are required to understand the underlying reasons for the findings, this could include looking at socioeconomic factors which could influence a patient’s expectations of the health service.”

Co-author Professor Philip Wilson, Director of the University of Aberdeen’s Centre for Rural Health in Inverness, said: “This work gives a unique insight into patient experience in both rural and urban general practice and it was made possible by the fact that satisfaction data had been collected routinely from patients registered with all general practices within the Scottish national health service.

“This service provides care to almost the entire population. Finding consistently higher satisfaction with remote and rural general practice is important. It provides a very positive message to new doctors considering a career in rural general practice. It appears that personal continuity of care, which we know is strongly correlated with good health outcomes, is also very connected with overall satisfaction and this is another very important message for the health service more generally.”

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