Open Access Highly Accessed Research article

Perceptions of quality in primary health care: perspectives of patients and professionals based on focus group discussions

Renata Papp1*, Ilona Borbas2, Eva Dobos1, Maren Bredehorst3, Lina Jaruseviciene4, Tuulikki Vehko5 and Sandor Balogh1

Author Affiliations

1 National Institute of Primary Health Care, 84-88 Jász Str, Budapest 1135, Hungary

2 National Institute for Quality- and Organizational Development in Health Care and Medicines, 1 Hold Str, Budapest 1054, Hungary

3 University of Bielefeld, 25 Universitäts Straße, Bielefeld 33615, Germany

4 Lithuanian University of Health Sciences, 2 Eivenių, Kaunas 50009, Lithuania

5 National Institute for Health and Welfare, 166 Mannerheimintie, Helsinki, Finland

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BMC Family Practice 2014, 15:128  doi:10.1186/1471-2296-15-128

Published: 28 June 2014



The EUprimecare project-team assessed the perception of primary health care (PHC) professionals and patients on quality of organization of PHC systems in the participating countries: Estonia, Finland, Germany, Hungary, Italy, Lithuania and Spain. This article presents the aggregated opinions, expectations and priorities of patients and professionals along some main dimensions of quality in primary health care, such as access, equity, appropriateness and patient- centeredness.


The focus group technique was applied in the study as a qualitative research method for exploration of attitudes regarding the health care system and health service. Discussions were addressing the topics of: general aspects of quality in primary health care; possibilities to receive/provide PHC services based on both parties needs; determinant factors of accessibility to PHC services; patient centeredness. The data sets collected during the focus group discussions were evaluated using the method of thematic analysis.


There were 14 focus groups in total: a professional and a patient group in each of the seven partner countries. Findings of the thematic analysis were summarized along the following dimensions: access and equity, appropriateness (coordination, continuity, competency and comprehensiveness) and patient centeredness.


This study shows perceptions and views of patients in interaction with PHC and opinion of professionals working in PHC. It serves as source of criteria with relevance to everyday practice and experience. The criteria mentioned by patients and by health care professionals which were considered determining factors of the quality in primary care were quite similar among the investigated countries. However, the perception and the level of tolerance regarding some of the criteria differed among EUprimecare countries. Among these dissimilar criteria we especially note the gate-keeping role of GPs, the importance of nurses' competency and the acceptance of waiting times. The impact of waiting time on patient satisfaction is obvious; the influence of equity and access to PHC services are more dependent on the equal distribution of settings and doctors in urban and rural area. Foreseen shortage of doctors is expected to have a substantial influence on patient satisfaction in the near future.

Quality; Primary health care; Patient satisfaction; Gate-keeping