The quality of GP consultation in two different salary systems

Abstract

Objective: To compare the quality of consultations between two Finnish employment contract systems: the capitation-based contract (CB) and the time-based contract (TB).

Design: Cross-sectional study based on paired questionnaires answered by patients and general practitioners (GPs).

Setting and subjects: 81 GPs with their patients from four health care centres in Finland, 2191 encounters.

Main outcome measures: Both patients' and GPs' opinions on the role of personal doctor, medico-professional quality, quality of communication, consultation conditions, economic quality (= number of examinations and treatments), and duration of consultation.

Results: Patients were more satisfied than the doctors with the quality of consultations. We found no differences between the groups in the patients' opinions on the quality. The GPs in the CB group rated their work quality higher than the GPs in the TB group. The patients' and the GPs' understanding of the GP as a personal doctor varied so that the patients considered their GP as their personal doctor more often than the GPs in question.

Conclusions: The GPs with a capitation-based contract evaluated the quality of their work higher than other GPs. Patient satisfaction was not dependent on the GP's contract.