Patients' perceptions of primary health care in an inner-city practice.

Abstract

BACKGROUND: The 1978 Alma Ata declaration by the World Health Organization emphasized the importance of primary health care, which includes social services and participation, as well as primary medical care. In the UK, primary medical care is based on general practice, increasingly working from purpose-built premises with primary care teams. However, this does not usually include social services or involve patient participation. Both general practice and social services are undergoing reorganization as separate entities, with little emphasis on intersectoral collaboration. OBJECTIVES: We aimed to assess patients' perceptions of primary health care in an inner-city practice in terms of primary medical care, social services and participation. METHODS: Perceptions of medical and social services, together with levels of satisfaction and patient participation, were assessed by self-completed questionnaires for 248 patients attending an inner-city health centre and by 74 home interviews for those who had requested house calls. RESULTS: Patients were more satisfied with primary medical care than with other aspects of primary health care, such as housing. Older patients at home were less satisfied with primary medical care and more satisfied with social services than younger patients attending the health centre. Physiotherapy, chiropody and pharmacy were the services most requested at the health centre. A domiciliary pharmacy, help with hearing aids and a social worker at the health centre were the main requests by older patients at home. CONCLUSIONS: Medical and social services at primary care level should have coterminous boundaries based on general practice populations, ideally with access through multipurpose health centres.