Meeting patient expectations of care: the major determinant of satisfaction with out-of-hours primary medical care?

Background: Client or consumer expectation is considered to influence their satisfaction with the service provided, but its importance has not been quantified in health care.

Objective: The aim of this study was to determine the effect of "patient expectations of care" on satisfaction with care provided by out-of-hours services.

Methods: We surveyed 3457 patients who requested out-of-hours care from five practices, two general practice out-of-hours co-operatives and a deputizing service in an English health authority during late 1997.

NHS walk-in centres and the expanding role of primary care nurses.

Forty pilot NHS walk-in centres have opened over the past two years to provide drop-in nurse-led primary care in England without the input of doctors. As such, these centres represent a revolution for nurse-led care in the health service. However, research suggests that there is considerable variation in the degree of autonomy and independence exercised by the nurses in the different centres.

A comparison of individual and population smoking data from a postal survey and general practice records.

Background: Data on smoking held by general practitioners (GPs) may contribute to clinical care and to an assessment of population health. However, these data are prone to several biases and their validity has not been tested.

Aim: To examine the accuracy of general practice data as an estimate for population prevalence of smoking and to estimate the accuracy of GP data on individuals' smoking habit compared with self-report.

Comparison of video-recorded consultations with those in which patients' consent is withheld.

Background: Video-recorded consultations are widely used for research in general practice. Recently, video recordings have begun to be used for the purposes of general practitioner (GP) registrar assessment. It is unknown, however, whether consultations in which patients withhold consent for recording differ from those that are recorded.

Reliability and validity of a new measure of patient satisfaction with out of hours primary medical care in the United Kingdom: development of a patient questionnaire.

Objective: To develop a reliable, valid measure of patient satisfaction with out of hours care suitable for large scale service evaluation.

Design: Focus group meetings and semistructured interviews with patients to identify issues of importance to patients and possible questionnaire items; interviews and two pilot studies to test and identify new questionnaire items; modification or removal of items to eliminate ambiguity and reduce non-response and skewed responses; questionnaire survey of out of hours care.

Setting: Greater Manchester and Leicester.