Towards the new primary care reform in Greece: a focus on patients’ expectations, views and perceptions from rural healthcare centres

Background: Patients’ perception of quality of care is an essential component in evaluating health care delivery. This paper reports data from Primary Health Care (PHC) Centers before the last PHC reform, undertaken to offer some baseline information about patient experience, support the decision-making processes taking place, and provide valuable input for future policy-making comparisons in Greece.
Participants and Methods: The research was conducted across the 16 Primary Health Care Centers (PHCCs) of Epirus from June to September 2017, with 532 patients rating the importance of different aspects of three main healthcare domains (clinical behavior, support and services, and organization of care) of PHC provision. The Greek version of EUROPEP was implemented for research purposes. Univariate comparisons were performed for patients with and without chronic disease, using Pearson’s chi-squared test for categorical data.
Results: Study's findings support that the 'organization of care' domain is of highest importance and priority, with "clinical behavior" and "support and services" following closely. Among recruited patients, on average, only a 2.1% of patients with a chronic disease were satisfied (rated 4 or 5 on the Likert scale) with the 'organization of care' aspects under consideration, compared to 18.4% of patients without a chronic disease. Furthermore, only 4% of patients with a chronic disease were satisfied with the aspects examined in the 'clinical behavior' domain, compared to 27% of patients without a chronic disease. Finally, 18% of sampled patients with a chronic disease reported being satisfied with the quality of 'support and services' provided, compared to 38% of patients without a chronic disease.
Conclusion: It is necessary to "back-up" available information from the past to afterward estimate reform imprinting on expectations and perceptions. The items and aspects of EUROPEP, in line with the new tasks of the "Personal Doctor" within the PHC system that patients perceive as most essential, can be used to prioritize quality improvement activities to strengthen PHC delivery in Greece. Communication skills, practices, and behavioral change skills seem to need more attention for an efficient PHC model.
Keywords: cross-sectional study, general practice, patients’ expectations, patients’ satisfaction, primary health care, primary care reform, quality of health care.