Does increased standardisation in health care mean less responsiveness towards individual patients’ expectations? A register-based study in Swedish primary care

• Main Authors: Anna Häger Glenngård, Anders Anell
• Format: Article
• Language: English
• Published: SAGE Publishing 2017-04-01
• Series: SAGE Open Medicine
• Online Access: https://doi.org/10.1177/2050312117704862

Objective: We explore whether standardisation in health care based on evidence on group level and a public health perspective is in conflict with responsiveness towards individual patient’s expectations in Swedish primary care. Methods: Using regression analysis, we study the association between patient views about providers’ responsiveness and indicators reflecting provider’s adherence to evidence-based guidelines, controlled for characteristics related to providers, including patient mix and degree of competition facing providers. Data were taken from two Swedish regions in years 2012 and 2013. Results: Patients’ views about responsiveness are positively correlated with variables reflecting provider’s adherence to evidence-based guidelines regarding treatment of elderly and risk groups, drug reviews and prescription of antibiotics. A high overall illness, private ownership and a high proportion of all visits being with a doctor are positively associated with patient views about responsiveness. The opposite relation was found for a high social deprivation among enrolled individuals and size of practice. There was no systematic variation with respect to the degree of competition facing providers. Conclusion: Results suggest that responsiveness towards individual patient expectations is compatible with increased standardisation in health care. This is encouraging for health care providers as they are challenged to balance increased demands from both patients and payers.