Do the organizational reforms of general practice care meet users’ concerns? The contribution of the Delphi method
Article first published online: 17 JUN 2011
© 2011 Blackwell Publishing Ltd
Volume 16, Issue 1, pages 3–13, March 2013
How to Cite
Krucien, N., Le Vaillant, M. and Pelletier-Fleury, N. (2013), Do the organizational reforms of general practice care meet users’ concerns? The contribution of the Delphi method. Health Expectations, 16: 3–13. doi: 10.1111/j.1369-7625.2011.00698.x
- Issue published online: 5 FEB 2013
- Article first published online: 17 JUN 2011
- Accepted for publication 27 April 2011
- Delphi technique;
- doctor–patient relationship;
- general practice care;
- health care reforms;
- patients’ priorities
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.