Measurement of Patient Preferences in Ambulatory Health-Care Centres (MVZ) - A Comparison of Quality of Treatment between MVZ and Family General Practitioners

Objective: The measurement of patient preferences on the basis of perceived quality of care in a comparison of two ambulatory health-care centres (medizinisches Versorgungszentrum, MVZ) with traditional ambulatory care consisting of single ambulatory practices was undertaken. The influence of the patients' perceived quality of care on patients' preference for an MVZ or traditional ambulatory care setting was analysed. Determinants of the patients' preference were identified. Methods: 310 questionnaires were distributed to patients in 2 MVZ. The preference measurement is derived from a comparison of 17 quality items in MVZ and traditional ambulatory care settings. Quality items were derived from the literature. The developed research instrument consists of 17 items on a 7-point Likert scale (1 = much better to 7 = much worse). T-Tests were used to test if the quality of care in MVZ was rated significantly differently in comparison to traditional ambulatory care. The determinants of the patients' preference were identified using a stepwise multiple regression analysis. Results: 310 questionnaires were handed out and the response rate was 92.3% (n = 286). 15 out of 17 quality items were rated in favour of the MVZ. Determinants of the patients' preference were the following (n = 286, corrected R-2 = 0.29): (1) time doctors take for the patient's treatment, (2) medical competence of doctors, (3) counselling regarding preventive examinations (p<0.01). Conclusions: The judgment in favour of the ambulatory health-care centres (MVZ) could be explained by organisational structures typical of these centres, e.g., the increased information sharing and cooperation amongst doctors. The identified determinants of the patients' "preference" indicate a practical approach for attaining a preference position in the health market, both for medical care centres as well as for single medical practices.