Satisfaction with primary health care in patients with upper respiratory tract infection: a three-level approach

BACKGROUND: Upper respiratory tract infections (URTI) are common conditions for which individuals seek health care. The present study analyzes the satisfaction of URTI patients with general practitioners offering conventional treatment, alternative treatment, or a combination of both. PATIENTS AND METHODS: Patients' satisfaction with care was evaluated based on concepts of structure, process and outcome. Data were drawn from a nationwide cross-sectional survey, conducted in Switzerland, which evaluated conventional (COM) and complementary and/or alternative medicine (CAM). Participating physicians provided information about care structure. A questionnaire filled in by doctors and patients in parallel during the first visit provided information about the process of care (e.g. patients' general health, duration and severity of symptoms, co-morbid conditions, diagnostic/therapeutic procedures and consultation time). One month later, patients completed a second questionnaire on their subjective disease- and treatment-related health status, beliefs and fulfillment of expectations, and treatment effects (outcome). RESULTS: Structural and procedural differences were found. The most striking was the significantly longer consultation time with CAM physicians. Patients' satisfaction as an outcome variable, however, did not differ between the different treatment approaches. CONCLUSIONS: General practitioners, offering a variety of treatments, accommodate an important demand in primary health care. Regardless of differences in structure and procedure of the practice types, patients perceive equal benefits of treatment after one month. Nonetheless, possible long-term effects of longer consultations in CAM practices, such as a possibly more stable long-term amelioration of health, have to be carefully evaluated in future studies with the same study design.