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Commonwealth Fund survey among general practitioners in ten countries: Norwegian results in 2015 and changes over time

General practitioners have more positive perceptions of the health care system and a higher job satisfaction than the average of the nine other countries that participated in the survey. The general practitioners in Norway scores worse than other countries in several areas. Nevertheless, when comparing the Norwegian results from the three surveys conducted in the period 2009-2015, there are positive developments in several areas.


  • Year: 2015
  • Authors Steiro A, Haugum M, Sjetne IS, Bjertnæs OA, Lindahl AK og Nylenna M.

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Key message

The Commonwealth Fund survey in 2015 shows that Norwegian general practitioners have higher job satisfaction and are more positive to the health service system than the average of the nine other countries that participated in the survey. Even though general practitioners in Norway still make less use of quality measurements, compared with the other countries, there are some positive changes over time. An interesting finding is that one out of three general practitioners, both in Norway and “Other countries" respond that the patients receive too much medical help.  

Compared with the other countries, Norway scores better on these areas:

  • General practitioners' job satisfaction and their views on how the health system works
  • The scope of problems related to payment for medicines and other costs
  • Their opportunity to get specialized diagnostic tests
  • Whether the general practitioners feel well prepared to receive different patient groups
  • Electronic information exchange with other services
  • Procedures for communication with other health professionals offering help in the home

Compared with the other countries, Norway scores worse on these areas:

  • Systems for quality measurement: This applies to both clinical measurements and patient experiences, and includes few opportunities to annually compare their own performance with other general practitioners.
  • General practitioners have to a lesser extent routine conversations about the need for health care with the elderly and the sick who cannot make decisions on their own behalf
  • Coordination of treatment, especially the time it takes from patients’ discharge to the general practitioner receives the necessary information from the hospital and gets access to the journal from other services when needed
  • Follow-up of patients between consultations, and coordinated follow-up with hospitals when it comes to discharged patients
  • Online services for patients, including the possibility of sending medical questions by e-mail and access to their own journal online
  • Generation of different types of lists using a computerized process, such as a list of patients who are due or overdue for tests or preventive care. This also result in less routine use of such activities towards patients in Norway, for example, reminders about preventive or follow-up care

Summary

Background

Norway, by the Norwegian Knowledge Centre for the Health Services, is participating in the Commonwealth Fund’s (CMWF) annual international survey of health care systems. The target group for questions about various aspects of health care in 2015 was general practitioners.

Objective

The survey is part of CMWFs "International Health Policy"-program. The aim of the program is to provide a basis for rethinking health policy and to provide input for decision-makers in the participating countries.

Method

The survey was conducted in ten countries, Australia, Canada, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland, UK and USA.

The questionnaire included questions about general opinions about the health care system, access to care and caring for patients, providing patient care, chronic care management, care coordination, end-of-life discussion and advance care planning, office systems and information technology, measuring practice improvement, and practice profile and demographic data. The questionnaire was identical in all participating countries, but each country had the opportunity to include 3-5 specific questions. In the Norwegian survey we included three question about the general practitioners’ assessment of care for cancer patients.

A representative sample of general practitioners was included. Of the 4 545 general practitioners 2 000 were drawn at random to participate in the survey. The questionnaire was sent by mail to the general practitioners’ office address. In all the participating countries, the survey was conducted in March through June 2015, with varying data collection methods (11). The material was weighted to make the data representative of the survey population in each participating country.

Results

The response rate in the participating countries ranged from 19 to 46 per cent and the sample sizes varied from 2 904 in Sweden to 503 in New Zealand. In Norway, 864 interviews were conducted, which gave a response rate of 44.

The Commonwealth Fund survey in 2015 shows that the Norwegian general practitioners have more positive views on the country's health care system and higher job satisfaction than the average of the responses in the nine other countries that participated in the survey. Norway scores worse than other countries in several areas, for example, quality measurements are used to a lesser extent than in other countries.

When we compare the results with previous studies in 2012 and 2009, we can see a positive development in many areas in Norway. These include the views on the health care services, the use of journal systems and ICT and quality measurements.

One out of three general practitioners, both in Norway and “Other countries" respond that the patients receive too much medical help.  

Compared with the other countries, Norway scores better on these areas:

  • General practitioners' job satisfaction and their views on how the health system works
  • The scope of problems related to payment for medicines and other costs
  • Their opportunity to get specialized diagnostic tests
  • Whether the general practitioners feel well prepared to receive different patient groups
  • Electronic information exchange with other services
  • Procedures for communication with other health professionals offering help in the home

Compared with the other countries, Norway scores worse on these areas:

  • Systems for quality measurement: This applies to both clinical measurements and patient experiences, and includes few opportunities to annually compare their own performance with other general practitioners.
  • General practitioners have to a lesser extent routine conversations about the need for health care with the elderly and the sick who cannot make decisions on their own behalf
  • Coordination of treatment, especially the time it takes from patients’ discharge to the general practitioner receives the necessary information from the hospital and gets access to the journal from other services when needed
  • Follow-up of patients between consultations, and coordinated follow-up with hospitals when it comes to discharged patients
  • Online services for patients, including the possibility of sending medical questions by e-mail and access to their own journal online
  • Generation of different types of lists using a computerized process,   such as a list of patients who are due or overdue for tests or preventive care. This also result in less routine use of such activities towards patients in Norway, for example, reminders about preventive or follow-up care

Conclusion

General practitioners have more positive perceptions of the health care system and a higher job satisfaction than the average of the nine other countries that participated in the survey. The general practitioners in Norway scores worse than other countries in several areas. Nevertheless, when comparing the Norwegian results from the three surveys conducted in the period 2009-2015, there are positive developments in several areas.

This is a publication from the Norwegian Knowledge Centre for the Health Services. The Knowledge Centre became part of the Norwegian Institute of Public Health 01/01/2016.