Introduction
The importance of primary care role on health outcomes of population
have been studied and has been proven to be beneficial. Patients who
visit their GPs more often, and used them as the main source of
information related to their health status, are more likely to were more
likely to be healthier (regardless of their initial health status and
socio-demographic characteristics), hospitalized less, and spent less on
annual healthcare expenditures. In addition, the existence of primary
care in a healthcare system has been proved to increase patient
satisfaction.
Patient satisfaction is one of the main drivers of quality in
healthcare. It is one of the important measures for the evaluation of
healthcare services and also a predictor for health outcomes. A critical
setting for most healthcare system is the primary care in which
interaction with providers may carry different perceptions of quality of
care and satisfaction. Since the 1990 and according to Donabedian
declaration of quality, patient perception has been incorporated into
quality assessment. In more recent years several approaches have been
adopted from other industries, such as the retail market and have
adopted patient satisfaction surveys to quality improvement tools.
Historically most European countries have adopted patient satisfaction
as a quality improvement tool. Some example are: in 1996, evaluation of
patient satisfaction was mandated to all French hospitals, in Germany,
measuring satisfaction has been required since 2005 as an element of
quality management reports and in England’s NHS, since 2002, the
Department of Health (DOH) has launched a national survey program in
which all NHS trusts have to survey patient satisfaction on an annual
basis and report the results to their regulators. Many other countries
have adopted the use of patient satisfaction tool as a quality
improvement tool indicating that patient satisfaction is a legitimate
indicator for improving the services and strategic goals for all
healthcare organizations.
The literature shows a wide range of available patient satisfaction
instruments i.e., the WHO Primary Care Assessment Tool (PCET); the
Primary Care Assessment Survey (PCAS); the Primary Care Assessment Tool
(PCAT); the Components of Primary Care Index (CPCI); the EUROPEP; the
Interpersonal Processes of Care (IPC) Survey; the General Practice
Assessment Questionnaire (GPAQ) for measuring patients’ experiences,
views, or satisfaction with GPs.
The EUROPEP is an internationally recognized and validated instrument
which is widely used for the survey of the patients’ opinion. It asks
patients to assess their regular GP, taking into account experiences
over the previous 12 months. The tool has been studied in several
countries of Europe already. More specifically, it has been used in
about 20 countries and has been translated into 15 countries. Thus, it
is of a high interest to explore the properties of the Greek version of
EUROPEP and its several quality indicators, as well as to assess its
robustness under by using it electronically in light of the pandemic
crisis in Cyprus that it has never been used.
In Cyprus, after the major healthcare reformation of 2019 which saw the
implementation of a universal health system and the establishment of
primary care, no study to assess patient satisfaction have been
performed. Such studies were not performed even before the establishment
of the new NHS as primary care was existing mostly on a private basis
and there was no way of being able to capture the patients which were
visiting GPs. As such Cyprus never took part in the European primary
care comparison, therefore there was a gap that needed to be complete.
Considering the current Covid-19 pandemic a special online survey using
the Greek version of the EUROPEP tool was conducted to evaluate patient
satisfaction with general practice. To our knowledge, this is the first
study of patient satisfaction in which the Greek version of the
questionnaire was used in Cyprus.