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.