Trusted GPs key to positive patient experience: Landmark study

Patients with chronic diseases who have a trusted and long-standing relationship with their GP experience better person-centred care and improved health outcomes, landmark global research reveals.
 
The inaugural Patient-Reported Indicator Survey (PaRIS) gathered data in 2023 from 107,000 patients and 1800 primary care practices across 19 countries, including 2400 Australian patients from 54 general practices.
 
Patients were aged 45 years and over, had at least one chronic condition, and had visited a GP in the prior six months.
 
The global study is an initiative of the Organisation for Economic Co-operation and Development (OECD), and on Thursday, the Australian Commission on Safety and Quality in Health Care released its own report into Australia’s PaRIS highlights.
 
Results show 97% of patients who saw the same GP for the past 3–5 years rated their care positively. There were also highly positive experiences when it came to quality of care (94%), person-centred care (94%) and coordination of care (74%).
 
In the area of person-centred care, patients valued many aspects of care including being provided with tailored care plans, having goals discussed, receiving written instructions and the recording of self-management goals in medical records.
 
For care coordination, a higher share of those with three or more chronic conditions rated care coordination positively (78%) compared to those with fewer chronic conditions (72%), which suggests that care coordination is being targeted to those who need it the most, the Commission report said.
 
‘Care coordination experiences were more positive for patients who had an established relationship with a healthcare professional,’ the report stated.
 
‘The longer the relationship and the more frequent the contact, the more positive the experience of care coordination.’
 
Longer GP-patient relationships also correlated with higher levels of trust in their healthcare professional and improved quality of care.
 
Patients seeing the same GP for more than one year reported 87% trust in their GP versus 77% for those who saw the same GP for less than one year.
 
Likewise, 95% of patients with a longer-term GP rated their care as good to excellent compared to 88% of those who had seen their GP for less than a year.
 
Clinical Director at the Commission and former RACGP President Associate Professor Liz Marles said the results demonstrate ‘the importance of a trusted, long-standing relationship between the patient and a GP’.
 
‘The areas where we performed really well were around patient experiences like patient-centered care, coordination of care, and the quality of care – these are all really important areas and it’s great to see that our patients are rating that very highly in Australian general practice,’ she told newsGP.
 
‘It actually provides evidence to what a lot of GPs intuitively know, which is that having a continuous relationship with a GP delivers better health outcomes. It also increases trust, trust in the GP, but also trust in the health system more generally.’
 
Also of note is the finding that 96% of patients who accessed telehealth rated their quality of care positively. This was a similar rating to in-person care, which indicates telehealth is a valuable tool for patients.
 
‘Practices should make sure patients are aware of the digital health services that are provided, so that we can improve access for them that way, providing continuity of care,’ Associate Professor Marles said.
 
‘This study is just showing that all of those efforts are making a difference to patient outcomes and how they perceive the healthcare system, which is really positive.’
 
The PaRIS study showed Australia performed better than, or close to, the OECD average in 10 health areas measured, ranking in the top five countries for quality of care, coordination of care, person-centred care and physical health.
 
Patient outcomes were also higher than the OECD average for general health.
 
RACGP President Dr Michael Wright said this study ‘reinforces the importance of GP care and continuity of care in supporting positive patient experiences’.
 
What this data shows, and what the college has been saying for a long time is that there’s no substitute for the care that you get from a GP who knows you, and it’s important that we avoid changes that might fragment care or reduce patients’ ability to get that care from their GP when they need it,’ he told newsGP.
 
‘GPs are the experts in providing long-term, whole-person care, and we need to make sure that that’s supported.
 
‘What we are seeing is that this type of care is the most efficient use of funding in our health system, and these results show that it gives the best patient satisfaction.’
 
In Australia the burden of chronic disease is high, with one in two Australians having at least one chronic condition. In 2022–23, $82 billion was spent on treating chronic diseases.
 
The Commission’s report showed the five most common amongst the study population was high blood pressure (57%), arthritis or ongoing back and joint pain (45%), depression, anxiety or other mental health conditions (33%), breathing conditions (24%) and cardiovascular/heart conditions (23%).
 
Associate Professor Marles said while the results are positive overall for general practice, there are still areas of ongoing improvement, including mental health and the experience in rural areas.
 
‘We have more work to do to improve our social functioning, mental health and wellbeing [measures] which are close to the OECD average, so we need to better support patients in their activities and responsibilities at home, work and in the community,’ she said.
 
‘Mental health is a common chronic disease. We can see that from the data, it’s also a co-morbidity with a lot of other chronic diseases.
 
‘This study tells us that people who have got mental health issues don’t tend to do as well, so we need to make sure that just as we’re looking after their diabetes or respiratory issues, we also pay equal attention to their mental health and their social circumstances, so that, as much as possible, we empower them to take some control of their own health.’
 
She added that efforts should also continue to improve health outcomes for rural patients.
 
‘We know that people in rural areas have had difficulty accessing healthcare for quite a while, and there have been a lot of strategies in place to try and address that,’ Associate Professor Marles said.
 
‘What this shows is that we can’t take our foot off the pedal in terms of trying to get GPs to take up positions in rural locations. That’s got to be a priority for the government, and ideally we want to enable patients living in those areas to have longer term relationships with their GPs.’
 
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chronic disease continuity of care health outcomes multimorbidity primary care