English summary: Patient centredness not the reality in the care of coronary heart disease patients in primary care

Background

Patient centred care is one of the core competencies of general practice. Its deployment correlates with patient satisfaction and clinical outcomes. We report how different aspects of patient centred care are perceived by primary care coronary heart disease patients.

Methods

Data was collected in 2008-2009 from 13 health centres in different regions and of different sizes. Patients with coronary heart disease, recruited by general practitioners, filled in a Finnish translation of the Patient Assessment of Chronic Illness Care (PACIC) questionnaire as part of the European Practice Assessment of Cardiovascular Risk Management (EPA Cardio) study. The questionnaire consists of 26 statements that should hold true in a patient centered setting. Patients graded each statement on a 1-5 Likert scale according to how often the particular statement was true in their care. The distribution of this data was ascertained and analyzed.

Results

The mean age of responders (n = 236) was 72 years. In 15 of the 26 statements, more than 50% of patients were of the opinion that the statement "generally not" or "almost never" held true in their case. Altogether 47% of patients (95% CI 40%-53%) answered that their care plan could not be followed in everyday life and 66% of the patients (95% CI 60%-73% ) answered that they were not asked "what things they would like to discuss concerning their illness at that visit". Neverheless only 8% of patients (95% CI 4%-11%) were not satisfied with the organization of their care.

Conclusions

There is need for improvement in the patient centred care of Finnish coronary heart disease patients in primary care. Finnish patients seem to be happy with a modest quality of care.