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The European Journal of Public Health Advance Access published online on June 23, 2005
The European Journal of Public Health, doi:10.1093/eurpub/cki004
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© The Author 2005. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved
Received April 23, 2003
Accepted March 25, 2004

Article

European patients' views on the responsiveness of health systems and healthcare providers

Angela Coulter 1* and Crispin Jenkinson 1

1 *Picker Institute Europe, Oxford, UK

* To whom correspondence should be addressed.
Angela Coulter, E-mail: angela.coulter{at}pickereurope.ac.uk


  Abstract

Background: Responsiveness to patients is now seen as a key characteristic of effective health systems. This study aimed to learn more about European people's views on the responsiveness of their country's health systems and healthcare providers. Methods: Telephone survey with random samples of the populations in Germany, Italy, Poland, Slovenia, Spain, Sweden, Switzerland and the UK using random digit dialling. Results: Responses were obtained from 8119 people aged 16 and over. Just over half the respondents said that doctors always listened carefully to them, gave them time for questions and provided clear explanations. Respondents from Switzerland and the UK reported consistently high rates of satisfaction with doctors' communication skills, while respondents from Poland were significantly less satisfied. Younger people were more critical than older people. Expectations of patient involvement in treatment decisions were high, particularly among younger people, with 74% indicating a desire to be actively involved. Most respondents felt they should have a choice of primary care doctor, specialist doctor and hospital, but less than half felt they had sufficient information to make an informed choice. There were significant variations between the countries in reported levels of involvement and in satisfaction with opportunities for choice. Conclusions: The results suggest that many European patients want a more autonomous role in health care decision-making. Policy-makers and clinicians should consider how to narrow the gap between public expectations and patients' experience.

Keywords: doctor-patient communication; choice; responsiveness; shared decision-making.
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