Do the Organizational Reforms of General Practice Care Meet Users’ Concerns? The Contribution of the Delphi Method

Nicolas Krucien, Marc Le Vaillant, Nathalie Pelletier-Fleury

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

CONTEXT: The debate over primary care reform in France, as in most OECD countries, centres on questions about efficacy and accessibility. Do these reforms actually respond to the users' concerns?
OBJECTIVE: The objective of this study was to identify the importance that users attribute to different aspects of general practice (GP) care.
DESIGN: The method used was a variant of the classical Delphi approach, called Delphi 'ranking-type'. Between May and September 2009, 74 experts aged over 18 were recruited by 'snowballing' sampling. Three iterative rounds were required to identify the core aspects through a consensus-building approach.
RESULTS: It is shown that users attribute a very high importance to the 'doctor-patient relationship' dimension. The following aspects 'GP patient information about his/her illness', 'Clarity of communication and explanation', and 'Whether the GP seemed listen to the patient' were evaluated by 96% of the experts as being of high importance. The coordination of GP was also considered as a very important aspect for 85% of the experts. In contrast, the aspects that belong to the organizational dimension appeared to be of relatively low importance for users.
CONCLUSIONS: Our results support a comprehensive approach of care and argue in favour of care reorganization following the patient-centred model. To promote organizational care reforms through the prism of the doctor-patient relationship could thus be a fruitful way to insure a better quality of care and the social acceptability of the reforms.
Original languageEnglish
Pages (from-to)3-13
Number of pages11
JournalHealth Expectations
Volume16
Issue number1
Early online date17 Jun 2011
DOIs
Publication statusPublished - Mar 2013

Fingerprint

General Practice
Quality of Health Care
France
Primary Health Care
Consensus
Communication

Keywords

  • Delphi Technique
  • doctor-patient relationship
  • general practice care
  • health care reforms
  • patients' priorities

Cite this

Do the Organizational Reforms of General Practice Care Meet Users’ Concerns? The Contribution of the Delphi Method. / Krucien, Nicolas; Le Vaillant, Marc; Pelletier-Fleury, Nathalie.

In: Health Expectations, Vol. 16, No. 1, 03.2013, p. 3-13.

Research output: Contribution to journalArticle

Krucien, Nicolas ; Le Vaillant, Marc ; Pelletier-Fleury, Nathalie. / Do the Organizational Reforms of General Practice Care Meet Users’ Concerns? The Contribution of the Delphi Method. In: Health Expectations. 2013 ; Vol. 16, No. 1. pp. 3-13.
@article{a335ba38742f4e32bd54f3246741f74a,
title = "Do the Organizational Reforms of General Practice Care Meet Users’ Concerns? The Contribution of the Delphi Method",
abstract = "CONTEXT: The debate over primary care reform in France, as in most OECD countries, centres on questions about efficacy and accessibility. Do these reforms actually respond to the users' concerns?OBJECTIVE: The objective of this study was to identify the importance that users attribute to different aspects of general practice (GP) care.DESIGN: The method used was a variant of the classical Delphi approach, called Delphi 'ranking-type'. Between May and September 2009, 74 experts aged over 18 were recruited by 'snowballing' sampling. Three iterative rounds were required to identify the core aspects through a consensus-building approach.RESULTS: It is shown that users attribute a very high importance to the 'doctor-patient relationship' dimension. The following aspects 'GP patient information about his/her illness', 'Clarity of communication and explanation', and 'Whether the GP seemed listen to the patient' were evaluated by 96{\%} of the experts as being of high importance. The coordination of GP was also considered as a very important aspect for 85{\%} of the experts. In contrast, the aspects that belong to the organizational dimension appeared to be of relatively low importance for users.CONCLUSIONS: Our results support a comprehensive approach of care and argue in favour of care reorganization following the patient-centred model. To promote organizational care reforms through the prism of the doctor-patient relationship could thus be a fruitful way to insure a better quality of care and the social acceptability of the reforms.",
keywords = "Delphi Technique, doctor-patient relationship, general practice care, health care reforms, patients' priorities",
author = "Nicolas Krucien and {Le Vaillant}, Marc and Nathalie Pelletier-Fleury",
year = "2013",
month = "3",
doi = "10.1111/j.1369-7625.2011.00698.x",
language = "English",
volume = "16",
pages = "3--13",
journal = "Health Expectations",
issn = "1369-6513",
publisher = "Wiley-Blackwell",
number = "1",

}

TY - JOUR

T1 - Do the Organizational Reforms of General Practice Care Meet Users’ Concerns? The Contribution of the Delphi Method

AU - Krucien, Nicolas

AU - Le Vaillant, Marc

AU - Pelletier-Fleury, Nathalie

PY - 2013/3

Y1 - 2013/3

N2 - CONTEXT: The debate over primary care reform in France, as in most OECD countries, centres on questions about efficacy and accessibility. Do these reforms actually respond to the users' concerns?OBJECTIVE: The objective of this study was to identify the importance that users attribute to different aspects of general practice (GP) care.DESIGN: The method used was a variant of the classical Delphi approach, called Delphi 'ranking-type'. Between May and September 2009, 74 experts aged over 18 were recruited by 'snowballing' sampling. Three iterative rounds were required to identify the core aspects through a consensus-building approach.RESULTS: It is shown that users attribute a very high importance to the 'doctor-patient relationship' dimension. The following aspects 'GP patient information about his/her illness', 'Clarity of communication and explanation', and 'Whether the GP seemed listen to the patient' were evaluated by 96% of the experts as being of high importance. The coordination of GP was also considered as a very important aspect for 85% of the experts. In contrast, the aspects that belong to the organizational dimension appeared to be of relatively low importance for users.CONCLUSIONS: Our results support a comprehensive approach of care and argue in favour of care reorganization following the patient-centred model. To promote organizational care reforms through the prism of the doctor-patient relationship could thus be a fruitful way to insure a better quality of care and the social acceptability of the reforms.

AB - CONTEXT: The debate over primary care reform in France, as in most OECD countries, centres on questions about efficacy and accessibility. Do these reforms actually respond to the users' concerns?OBJECTIVE: The objective of this study was to identify the importance that users attribute to different aspects of general practice (GP) care.DESIGN: The method used was a variant of the classical Delphi approach, called Delphi 'ranking-type'. Between May and September 2009, 74 experts aged over 18 were recruited by 'snowballing' sampling. Three iterative rounds were required to identify the core aspects through a consensus-building approach.RESULTS: It is shown that users attribute a very high importance to the 'doctor-patient relationship' dimension. The following aspects 'GP patient information about his/her illness', 'Clarity of communication and explanation', and 'Whether the GP seemed listen to the patient' were evaluated by 96% of the experts as being of high importance. The coordination of GP was also considered as a very important aspect for 85% of the experts. In contrast, the aspects that belong to the organizational dimension appeared to be of relatively low importance for users.CONCLUSIONS: Our results support a comprehensive approach of care and argue in favour of care reorganization following the patient-centred model. To promote organizational care reforms through the prism of the doctor-patient relationship could thus be a fruitful way to insure a better quality of care and the social acceptability of the reforms.

KW - Delphi Technique

KW - doctor-patient relationship

KW - general practice care

KW - health care reforms

KW - patients' priorities

U2 - 10.1111/j.1369-7625.2011.00698.x

DO - 10.1111/j.1369-7625.2011.00698.x

M3 - Article

VL - 16

SP - 3

EP - 13

JO - Health Expectations

JF - Health Expectations

SN - 1369-6513

IS - 1

ER -