Comparative quality of outpatient services between primary care units in suburban areas and urban areas from patients' perspectives

Introduction: Primary care units (PCUs) has played an important role to provide healthcare services in response to patients’ needs. Two forms of PCUs are provided: urban PCUs and suburban PCUs. Despite a long period of care provision, little is known about the quality of services from the patients’ viewpoint especially comparing between two types of PCUs. This study compared thequality of outpatient services between primary care units in suburban areas and urban areas from patients' perspectives.Methods: A cross-sectional survey was conducted in patients who had visited the 2 urban PCUs and 27 suburban PCUs in Amphur Muang, Lampang from October 2015 to January 2016. Concerning the data collection, this study employed the Primary Care Unit Questionnaires, which evaluated the quality of care from various aspects, including access, continuity of care, physicians’ communication skills, enablement and overall satisfaction. Comparison between PCU groups was examined using a chi-square test and t-test, with a significance level of 0.05.Results: A total of 400 and 1,197 patients were included from urban and suburban PCUs, respectively. Results of the study showed that urban PCUs had a higher mean score of healthcare access than do their suburban counterparts (p < 0.001). Compared with the urban PCUs, the higher mean score of continuity of care was observed among the suburban group (p = 0.012). In addition,the mean score for enablement of suburban PCUs was higher than that of the urban PCUs (p = 0.001).Conclusion: In comparison with urban PCUs, this study pointed out that patients who received care at suburban PCUs reported a lower quality of care in terms of access to the facilities. As suburban PCUs shares the majority in the primary care service, efforts should be Increase the frequency of medical services and extend the service period at the suburban PCUs in response topatients’ needs.