Association between patients' recommendation of their GP and their evaluation of the GP

Objective. Patient priorities and patient evaluations indicate that accessibility should receive more attention to increase quality in general practice. The definition of family medicine emphasizes the patient-centred approach, communication skills, continuity, and clinical skills. We aimed to explore the associations between the 23 items in the Europep questionnaire measuring patient evaluation of general practice and the patients' recommendation of their general practitioner (GP) to friends and to study the relationship of these items with the core competences of family medicine. Design. Cross-sectional study where patients aged 18 years and over attending the practice were included. Patients completed the Danish version of the 23 item Europep questionnaire and an additional item about the degree to which they could recommend their GP to friends. Setting. Danish general practice (the DanPEP study). Subjects. A total of 50 191 patients and 690 GPs were included in the analyses. Main outcome measures. For each item, associations were calculated between a positive answer and the degree to which the patient could recommend the GP. Analyses were made at patient and GP levels. Results. We found 12 items that covered the 10 most strongly associated items from both analyses: four of six items from the doctor-patient relationship, two of five items from medical care, and all items from information and support and organization of services. No items from accessibility were among the 12 items. Conclusions. Recommending the GP to others was most strongly associated with the emphatic, patient-oriented, informative and coordinating, and competent/skilled GP and to a lesser degree with accessibility to general practice.