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- Figure 1 'Will people with the following complaints usually visit a GP?' The columns indicate the percentage of patients that answered 'yes' or 'probably yes', and GPs that answered 'almost always' or 'usually' (details in Tables 2 and 3). For deteriorating vision, anxiety, and sexual problems, the differences were significant when analysed by multiple logistic regression, correcting for GPs’ and patients’ age and sex, location of GP practice, and GPs' list size (Table 4)
Tables
Questions from the GP questionnaire In case of the following health problems, to what extent will patients in your practice population contact you as the first doctor?a (Only first contact, not for further diagnosis or treatment) Possible answers: (Almost) always, Usually, Occasionally, Seldom/Never Somatic problems Child with severe coughb Man aged 24 with stomach painb Woman aged 60 with deteriorating visionb Man aged 35 with sprained ankleb Woman aged 60 with polyuria Woman aged 60 with acute symptoms of paralysis/paresis Man aged 70 with joint pains Woman aged 75 with moderate memory problems Child aged 8 with hearing problem Man aged 28 with a first convulsion Man aged 45 with chest pain Woman aged 50 with a lump in her breast Woman aged 18 asking for oral contraception Psychosocial problems Man aged 32 with sexual problemsb Physically abused child aged 13 Anxious man aged 45b Couple with relationship problemsb Woman aged 50 with psychosocial problems Man aged 52 with alcohol addiction problems Questions from the patient questionnaire Would most patients visit their GP for the following conditions? Possible answers: Yes, Probably yes, Probably not, No, Don’t know Somatic problems Child with severe coughb Stomach painb Deteriorated visionb Sprained ankleb Cut finger that needs to be stitched Removal of a wart Blood in stool Help to quit smoking Psychosocial problems Sexual problemsb Domestic violence Anxietyb Relationship problemsb Other Routine health cheques Advice for choosing the best hospital/specialist How important would it be for you to see a doctor if you had…Possible answers: Extremely important, Rather important, Somewhat important, Not important Somatic problems Weight loss >2 kg in one month Shortness of breath with light exercise Chest pain when exercising Headache >1 day Abdominal pains >1 day Loss of consciousness/fainting Psychosocial Severe worries >1 month Do you expect to benefit from a visit to your GP for...Possible answers: Yes, No, Don’t know Somatic problems Stomach problems Diarrhoea Shoulder/neck pain Headache Flu Sore throat Feeling nauseous Feeling tired Psychosocial Feeling nervous Do you agree with the following statements?Possible answers: Strongly agree, Agree, Disagree, Strongly disagree In general, doctors can be trusted In general, people can be trusted aIn the English version of the questionnaire, the term 'first healthcare provider' was used, but in the Norwegian version this was translated to 'first doctor'.
bIncluded in regression analysis to compare responses from GPs and patients.
- Table 1 Demographics of patients (n = 1529) and GPs (n = 198) participating in the Norwegian part of the Quality and Costs of Primary Care in Europe (QUALICOPC) study, 2012–2013.
Total n (%) Female n (%) Male n (%) Patients Total 1529 (100.0) 916 (61.9)a 564 (38.1)a Ageb Range 18–93 18–91 18–93 Mean 48.7 46.2 52.5 GPs Total 198 (100.0) 77 (39.1)c 120 (60.9)c Age Range 28–69 28–68 28–69 Mean 45.7 43.4 47.0 Practice location d Large inner city 66 (33.8) 29 (38.7) 36 (30.3) Suburbs 27 (13.8) 12 (16.0) 15 (12.6) Small town 44 (22.6) 14 (18.7) 30 (25.2) Mixed urban–rural 31 (15.9) 7 ( 9.3) 24 (20.2) Rural 27 (13.8) 13 (17.3) 14 (11.8) Size of patient list c Range 250–1800 400–1500 250–1800 Mean 1093.4 1048.9 1122.6 aMissing data = 49. bMissing data = 59. cMissing data = 1. dMissing data = 3.
- Table 2. 'In case of the following health problems, to what extent will patients in your practice population contact you as the first doctor?' Responses from GPs (n = 198) who participated in the Norwegian part of the Quality and Costs of Primary Care in Europe (QUALICOPC) study, 2012–2013. Results given as valid percentages and ORs with 95% CIs, indicating the probability for the answer Always/Usually, with Occasionally/Never as reference by sex, age, list size, and practice location
Patient cases(age, years) na %(95% CI) GP sex(reference: female) GP age(reference: 36–59) List size(reference: 901–1300) Location of practice(reference: rural) Male ≤35 ≥60 ≤900 >1300 Urban Child severe coughb 194 98.5 (96.4 to 100.0) —i —i 0.1 (0.0 to 0.8)j 0.3 (0.0 to 5.4) 0.5 (0.0 to 12.1) 0.8 (0.1 to 14.9) Man (24) Stomach painc 189 96.9 (94.4 to 99.0) 0.9 (0.1 to 5.1) —i 0.7 (0.1 to 7.0) 0.8 (0.1 to 5.6) 1.2 (0.1 to 13.2) 2.2 (0.4 to 13.2) Woman (60) Deteriorated visionc 175 89.7 (85.6 to 93.8) 1.5 (0.6 to 3.9) 1.1 (0.3 to 4.1) 0.9 (0.2 to 4.6) 0.9 (0.3 to 3.1) 0.6 (0.2 to 1.9) 0.9 (0.3 to 2.8) Man (35) Sprained ankled 146 75.3 (69.1 to 81.4) 0.9 (0.4 to 1.7) 0.8 (0.3 to 2.0) 1.1 (0.3 to 3.6) 0.6 (0.3 to 1.5) 0.9 (0.4 to 2.1) 0.3 (0.1 to 0.9)j Woman (60) Polyuriac 187 95.9 (92.8 to 98.5) 0.9 (0.2 to 4.2) 0.5 (0.1 to 3.1) 0.6 (0.1 to 5.8) 0.9 (0.1 to 5.7) 1.1 (0.2 to 6.3) 0.3 (0.0 to 2.9) Woman (60) Acute paresisc 138 70.8 (64.1 to 76.9) 0.7 (0.3 to 1.3) 1.2 (0.5 to 3.2) 0.9 (0.3 to 2.7) 1.8 (0.8 to 4.4) 2.9 (1.2 to 7.0)j 0.2 (0.1 to 0.5)k Man (70) Joint paine 188 97.4 (94.8 to 99.5) 0.5 (0.1 to 5.1) 0.7 (0.1 to 7.4) 0.4 (0.0 to 4.0) 0.3 (0.0 to 3.9) 0.2 (0.0 to 2.6) 1.8 (0.2 to 16.1) Woman (75) Memory problemsd 180 92.8 (88.7 to 96.4) 0.7 (0.2 to 2.4) 0.3 (0.1 to 1.3) 0.3 (0.1 to 1.3) 1.0 (0.3 to 4.1) 1.1 (0.3 to 5.0) 0.8 (0.2 to 3.2) Child (8) Hearing problemsf 172 87.8 (82.7 to 92.3) 1.3 (0.5 to 3.4) 1.0 (0.3 to 3.4) 0.4 (0.1 to 1.5) 0.5 (0.2 to 1.4) 0.9 (0.3 to 3.2) 1.9 (0.7 to 5.9) Man (28) First convulsionsg 107 55.7 (49.0 to 63.0) 0.4 (0.2 to 0.8)j 1.0 (0.4 to 2.3) 2.3 (0.8 to 6.8) 2.3 (1.0 to 5.1)j 1.6 (0.7 to 3.5) 0.4 (0.2 to 0.8)j Man (24) Chest painc 172 88.2 (83.6 to 92.8) 0.5 (0.2 to 1.4) 4.2 (0.5 to 33.2) 1.0 (0.3 to 3.8) 2.2 (0.6 to 8.5) 1.0 (0.4 to 2.9) 0.7 (0.2 to 2.3) Woman (50) Breast lumpc 192 98.5 (96.4 to 100) 0.7 (0.1 to 9.0) —i —i 0.3 (0.0 to 4.5) —i 2.6 (0.2 to 35.0) Woman (18) Contraceptionf 169 86.2 (81.1 to 90.8) 0.3 (0.1 to 0.9)j 1.2 (0.3 to 4.7) 1.8 (0.4 to 7.5) 10.7 (2.1 to 54.0)j 0.8 (0.3 to 2.3) 4.5 (1.6 to 12.3)j Man (32) Sexual problemsd 142 73.2 (66.0 to 79.4) 1.4 (0.7 to 2.8) 2.5 (0.8 to 7.9) 0.6 (0.2 to 1.8) 1.1 (0.5 to 2.6) 1.4 (0.6 to 3.5) 1.3 (0.6 to 2.7) Child (13) Physical abuseh 73 38.6 (31.7 to 46.0) 0.7 (0.4 to 1.4) 0.9 (0.4 to 2.2) 1.6 (0.6 to 4.2) 1.4 (0.7 to 3.0) 1.5 (0.7 to 3.3) 0.6 (0.3 to 1.2) Man (45) Anxietye 183 94.8 (91.7 to 97.4) 1.2 (0.3 to 4.6) 0.7 (0.1 to 3.9) 0.9 (0.1 to 8.1) 0.8 (0.2 to 4.0) 0.5 (0.1 to 2.7) 1.1 (0.2 to 5.1) Relationship problemsg 77 40.1 (32.8 to 47.4) 0.7 (0.4 to 1.4) 0.8 (0.4 to 2.0) 0.8 (0.3 to 2.3) 1.2 (0.6 to 2.6) 1.4 (0.6 to 3.0) 0.6 (0.3 to 1.2) Woman (50) Psychosocial problemse 182 94.3 (90.7 to 97.4) 0.3 (0.1 to 1.6) —i 0.2 (0.1 to 0.9)j 1.4 (0.3 to 7.9) 5.7 (0.6 to 51.1) 0.5 (0.12.5) Man (52) Alcohol problemsc 117 60.0 (53.8 to 66.7) 1.1 (0.6 to 2.0) 1.6 (0.7 to 3.8) 0.5 (0.2 to 1.3) 1.1 (0.5 to 2.4) 1.6 (0.73.6) 1.1 (0.52.2) aGPs who answered always or usually. bMissing data = 1. cMissing data = 3. dMissing data = 4. eMissing data = 5. fMissing data = 2. gMissing data = 6. hMissing data = 9. iSystem missing due to overflow. j P<0.05. kStatistically significant (P≤0.002).
- Table 3. Patients’ views on anticipated healthcare-seeking behaviour. Responses from patients (N = 1529, n = valid responses) participating in the Norwegian part of the QUALICOPC study, 2012–2013. Results given as valid percentages and ORs with 95% CIs by sex, age, and location
1. Would most patients see their GP for the following conditions?ab Sex (reference: female) Age groups (reference: 30–65 years) Geographical location (reference: rural) Condition (valid response, n) Yes, n % (95% CI) Male OR (95% CI) Age <30 OR (95% CI) Age >65 OR (95% CI) Urban OR (95% CI) Child with severe cough (1372) 1295 94.4 (93.1 to 95.5) 0.6 (0.3 to 0.9)g 1.1 (0.5 to 2.3) 0.9 (0.5 to 1.8) 1.3 (0.7 to 2.2 Stomach pain (1411) 1307 92.6 (91.2 to 93.9) 0.8 (0.5 to 1.2) 0.7 (0.4 to 1.2) 1.2 (0.7 to 2.1) 1.1 (0.7 to 1.7) Deteriorated vision (1356) 927 68.4 (65.9 to 70.8) 1.1 (0.8 to 1.4) 0.8 (0.6 to 1.1) 1.5 (1.1 to 2.1)g 0.7 (0.5 to 0.9)g Sprained ankle (1364) 992 67.6 (65.1 to 70.0) 0.7 (0.5 to 0.9)f 0.8 (0.6 to 1.2) 1.9 (1.3 to 2.6)f 0.8 (0.6 to 1.0) Cut finger, needing stitches (1391) 1015 73.0 (70.6 to 75.3) 0.6 (0.4 to 0.7)f 0.6 (0.4 to 0.8)f 1.6 (1.1 to 2.4)g 0.6 (0.4 to 0.8)f Wart removal (1324) 1083 81.8 (79.7 to 83.8) 0.7 (0.5 to 1.0)g 0.8 (0.5 to 1.2) 0.9 (0.6 to 1.4) 1.2 (0.9 to 1.7) Blood in stool (1418) 1378 97.2 (96.2 to 98.0) 0.5 (0.3 to 1.0)g 0.5 (0.2 to 1.0)g 1.5 (0.5 to 3.9) 0.7 (0.3 to 1.6) Help to quit smoking (1118) 676 60.5 (57.6 to 63.3) 0.6 (0.5 to 0.8)f 0.9 (0.6 to 1.2) 0.9 (0.6 to 1.2) 1.0 (0.7 to 1.3) Sexual problems (1107) 680 61.4 (58.5 to 64.3) 1.3 (1.0 to 1.7) 1.0 (0.7 to 1.4) 0.8 (0.6 to 1.1) 1.0 (0.8 to 1.4) Domestic violence (1034) 603 58.3 (55.3 to 61.3) 0.9 (0.7 to 1.2) 0.7 (0.5 to 1.0)g 1.7 (1.2 to 2.4)g 1.0 (0.7 to 1.3) Anxiety (1284) 1085 84.5 (82.5 to 86.4) 0.4 (0.3 to 0.6)f 0.4 (0.3 to 0.6)f 1.0 (0.7 to 1.6) 1.0 (0.7 to 1.4) Relationship problems (1061) 338 31.9 (29.1 to 34.7) 0.8 (0.6 to 1.1) 0.7 (0.5 to 1.1) 1.9 (1.3 to 2.6)f 1.0 (0.7 to 1.4) Routine health cheque (1437) 1356 94.4 (93.1 to 95.5) 0.7 (0.4 to 1.2) 0.5 (0.3 to 0.9)g 1.6 (0.8 to 3.4) 1.0 (0.6 to 1.7) Advice for choosing hospital or specialist (1235) 1061 85.9 (83.9 to 87.8) 1.2 (0.8 to 1.7) 0.6 (0.4 to 0.9)g 1.9 (1.1 to 3.2)g 0.9 (0.6 to 1.4) 2. How important would it be for you to see a doctor if you had…?c Very important % Male OR (95% CI) Age <30 OR (95% CI) Age >65 OR (95% CI) Urban OR (95% CI) Weight loss >2 kg in one month (1431) 527 36.8 (34.4 to 39.3) 0.9 (0.7 to 1.2) 0.5 (0.4 to 0.7)f 2.3 (1.7 to 3.0)f 1.1 (0.8 to 1.4) Shortness of breath (1429) 792 55.4 (52.8 to 58.0) 1.1 (0.9 to 1.4) 0.6 (0.4 to 0.8)f 1.8 (1.3 to 2.4)f 1.2 (0.9 to 1.5) Chest pain when exercising (1424) 1136 79.8 (77.6 to 81.8) 1.0 (0.8 to 1.3) 0.5 (0.3 to 0.6)f 1.9 (1.3 to 2.9)g 1.0 (0.7 to 1.3) Headache >1 day (1415) 635 44.9 (42.3 to 47.5) 1.5 (1.2 to 1.9)f 0.8 (0.6 to 1.2) 1.7 (1.3 to 2.2)f 1.0 (0.8 to 1.3) Abdominal pains >1 day (1424) 746 52.4 (49.8 to 55.0) 1.3 (1.1 to 1.7)g 1.1 (0.8 to 1.5) 1.6 (1.2 to 2.1)f 0.9 (0.7 to 1.1) Loss of consciousness/fainting (1432) 1323 92.4 (90.9 to 93.7) 1.2 (0.8 to 1.8) 0.3 (0.2 to 0.5)f 1.4 (0.7 to 2.8) 0.8 (0.5 to 1.3) Severe worries >1 month (1429) 991 69.3 (66.9 to 71.7) 1.2 (0.9 to 1.5) 1.2 (0.9 to 1.7) 0.8 (0.6 to 1.0) 1.1 (0.8 to 1.4) 3. Do you expect to benefit from a visit to your GP for...?d Yes % Male OR (95% CI) Age <30 OR (95% CI) Age >65 OR (95% CI) Urban OR (95% CI) Stomach problems (1319) 1189 90.1 (88.5 to 91.7) 1.0 (0.6 to 1.4) 0.7 (0.5 to 1.2) 3.5 (1.7 to 7.4)f 1.0 (0.6 to 1.5) Diarrhoea (1296) 1022 78.9 (76.6 to 81.0) 1.0 (0.8 to 1.4) 0.6 (0.4 to 0.9)g 1.9 (1.2 to 2.9)g 1.4 (1.0 to 1.9)g Shoulder/neck pain (1295) 1037 80.1 (77.8 to 82.2) 1.2 (0.9 to 1.6) 0.6 (0.4 to 0.9)g 1.5 (1.0 to 2.2) 0.8 (0.5 to 1.1) Headache (1254) 862 68.7 (66.1 to 71.3) 0.8 (0.61.0) 1.0 (0.7 to 1.5) 1.0 (0.7 to 1.4) 1.2 (0.9 to 1.6) Flu (1301) 857 65.9 (63.3 to 68.4) 0.8 (0.6 to 1.1) 1.1 (0.8 to 1.6) 1.3 (1.0 to 1.8) 1.1 (0.9 to 1.5) Sore throat (1320) 867 65.7 (63.1 to 68.2) 0.8 (0.6 to 1.0)g 0.8 (0.6 to 1.1) 1.2 (0.9 to 1.7) 1.2 (1.0 to 1.6) Feeling nauseous (1205) 732 60.7 (58.0 to 63.5) 0.8 (0.6 to 1.0)g 0.8 (0.6 to 1.2) 1.2 (0.9 to 1.6) 1.4 (1.1 to 1.9)g Feeling tired (1168) 854 73.1 (70.5 to 75.6) 0.6 (0.4 to 0.8)f 0.6 (0.4 to 0.9)g 1.1 (0.7 to 1.6) 1.3 (1.0 to 1.8) Feeling nervous (1062) 699 65.8 (62.9 to 68.6) 0.8 (0.6 to 1.0) 0.5 (0.3 to 0.7)f 2.0(1.3 to 3.0)f 1.0 (0.7 to 1.3) 4. Do you agree with the following statements?e Agree % Male OR (95% CI) Age <30 OR (95% CI) Age >65 OR (95% CI) Urban OR (95% CI) In general, doctors can be trusted (1458) 1420 97.4 (96.5 to 98.1) 1.4 (0.73.1) 0.8 (0.4 to 2.0) 4.1 (0.9 to 17.3) 2.9 (1.4 to 5.7)g In general, people can be trusted (1396) 1064 76.2 (73.9 to 78.4) 0.9 (0.7 to 1.1) 0.4 (0.3 to 0.6)f 1.1 (0.8 to 1.5) 1.2 (0.9 to 1.7) aOR (95% CI), giving the probability of the answer 'Yes' (yes + probably yes); reference is 'No' (no + probably no). b'Don’t know' recoded to missing. cOR gives the probability of 'Important' (extremely + rather important); reference is 'not important' (somewhat + not important). dOR gives the probability for 'Yes', reference is 'No'. eOR gives the probability of 'Agree' (strongly agree + agree), reference is 'Disagree' (disagree+ strongly disagree). fStatistical significance of P≤0.002. g P<0.05.
CI = confidence intervals. OR = odds ratio.
- Table 4. Comparisons of patients’ and their GPs’ expectations regarding healthcare-seeking behaviour. Multiple logistic regression (GEE), corrected for patients’ age and sex, GPs’ age and sex, size of patient lists, and geographical location of practice. OR indicates the probability of the GPs answering Yes, with patients as reference group
Will people with the following complaints usually visit their GP? GPs (reference: patients) OR 95% CI P value Severe cough 3.4 1.1 to 10.5 0.04 Abdominal pain 2.7 1.2 to 6.5 0.02 Deteriorating vision 4.2a 2.5 to 6.9 <0.001 Sprained ankle 1.4 1.0 to 2.0 0.07 Anxiety 3.0a 1.5 to 6.0 0.002 Relationship problems 1.5 1.1 to 2.1 0.02 Sexual problems 1.8a 1.3 to 2.6 0.001 aIndicates significant differences, P≤0.002. CI = confidence intervals. GEE = generalised estimating equation. OR = odds ratio.
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