SUMMARY

The aim of the study is to evaluate attitude of physicians and patients towards primary health care reform.

The objectives: 1) to assess patients' attitude to primary health care reform and its relations to demographic and social factors.

2) to evaluate physicians' attitude to primary health care reform.

3) to compare viewpoint of patients and physicians on primary health care reform.

Methods. The subject of the survey is the attitude of the patients and physicians towards primary health care reform. The survey was conducted in five primary health care centres and three private primary health care practices in Prienai region. Of the 400 questionnaires handed out to patients 82.5% were returned and of the 112 questionnaires given to doctors 87.5% were returned. The participants in the survey were 330 patients and 98 medical doctors. The questionnaires were compiled both for the patients and the doctors. The questionnaire for the patients covered 24 questions, for the doctors - 19 questions. The data analysis was done applying the statistical package SPSS 11.0 version. The statistical procedures were employed by Chi-square’s (χ2) parameters, degree of freedom and statistical significance. The difference of indices were statistical significant at p<0.05.

Results. 55.9% of the patients’ attitude towards primary health care reform is positive, while 29.9% of the patients - negative. 18.3% of the patients have the opinion that due to health care reform the quality of health care improved, 16.7% state that the responsibility and attention to the patients got better, 16.7% claim that model of the health care system became similar to European model. 11.7% maintain that practice of the health care institution became more effective, 10.8% - that standing of the health system improved, 6.7% - that health system became more concerted, by the opinion of 5.8% - health system became more economical, 3.3% - intersectional collaboration improved. Less than a half of the patients (45.6%) are not completely satisfied, 33.6% - satisfied with primary health care services, 17.6% - completely satisfied and 3.2% dissatisfied with the services. About a half of the doctors (49%) are satisfied with their job, 20.4% - completely satisfied, 30.6% - not completely satisfied or dissatisfied. 51% of the doctors state, that no positive changes present due to health care reform, while 23.5% maintain improvement of the accessibility of the family physician, 7.1% - better quality of family physicians care, 5.1% - better prevention and health promotion, 4.1% - higher qualification of family physicians. By the opinion of 56.3% of doctors in primary health care centers and 29.4% in private practices no positive changes happened during the health care reform, but more private physicians (23.5%) in comparison with physicians in primary health care centers (3.1%) state about quality improvement and better accessibility. 35.3% private and 4.8% doctors in primary health care centers pointed out salary increase in a period of the health care reform. 11.8% private and 3.2% doctors in health centers indicated more possibilities to self-expression. More doctors in health centers (39.7%) than in private practice (5.9%) felt psychological tension because of health care reform.

Conclusions. More than a half of the patients and less than a half of doctors have a positive attitude towards primary health care reform. More than a half of the patients are satisfied with primary health care services, and more than two thirds of the doctors are satisfied with their job. More doctors in private practice than in primary health centers state that quality and accessibility of primary health care improved due to health reform, and the salary and possibilities to self-expression grew up.

Raktažodžiai: Pirminė sveikatos priežiūra, Primary health care