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Directing Improvements in Primary Care Patient Experience through Analysis of Service Quality

Hudson Smith, Mel; Smith, David


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Dr Mel Smith
Associate Professor in Strat & Ops Mngt

David Smith


© Health Research and Educational Trust Objective: To examine the influence of dimensions of service quality on patient experience of primary care. Data Sources/Study Setting: Data from the national GP Patient Survey in England 2014/15, with responses from 858,351 patients registered at 7,918 practices. Study Design: Expert panel and principal component analysis helped identify relevant dimensions of service quality. Regression was then used to examine the relationships between these dimensions and reported patient experience. Data Collection/Extraction Methods: Aggregated scores for each practice were used, comprising the proportion of positive responses to each element of the study. Principal Findings: Of eight service quality dimensions identified, six have statistically significant impacts on patient experience but only two have large effects. Patient experience is highly influenced by practice responsiveness and the interactions with the physician. Other dimensions have small or even slightly negative influence. Service quality provided by nurses has negligible effect on patient experience. Conclusions: To improve patient experience in primary health care, efforts should focus on practice responsiveness and interactions with the physician. Other areas have little influence over patient experience. This suggests a gap in patients’ perspectives on health care, which has policy implications for patient education.


Hudson Smith, M., & Smith, D. (2018). Directing Improvements in Primary Care Patient Experience through Analysis of Service Quality. Health Services Research, 53(6), 4647-4666.

Journal Article Type Article
Acceptance Date Apr 10, 2018
Online Publication Date Jun 3, 2018
Publication Date Dec 1, 2018
Deposit Date Apr 12, 2018
Publicly Available Date Jun 4, 2020
Journal Health Services Research
Print ISSN 0017-9124
Electronic ISSN 1475-6773
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 53
Issue 6
Pages 4647-4666
Keywords patient experience, service quality, GP Practice
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Additional Information Additional Information : This is the peer reviewed version of the following article: Hudson Smith, M. and Smith, D. (2018) Directing improvements in primary care patient experience through analysis of service quality. Health Services Research. ISSN 1475-6773 Available from:], which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.


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