Doctor-patient communication in different European health care systems: Relevance and performance from the patients' perspective

A. van den Brink-Muinen, P. F.M. Verhaak, J. M. Bensing, O. Bahrs, M. Deveugele, L. Gask, F. Leiva, N. Mead, V. Messerli, L. Oppizzi, M. Peltenburg, A. Perez

Research output: Contribution to journalResearch Articlepeer-review

78 Scopus citations


Our aim is to investigate differences between European health care systems in the importance attached by patients to different aspects of doctor-patient communication and the GPs' performance of these aspects, both being from the patients' perspective. 3658 patients of 190 GPs in six European countries (Netherlands, Spain, United Kingdom, Belgium, Germany, Switzerland) completed pre- and post-visit questionnaires about relevance and performance of doctor-patient communication. Data were analyzed by variance analysis and by multilevel analysis. In the non-gatekeeping countries, patients considered both biomedical and psychosocial communication aspects to be more important than the patients in the gatekeeping countries. Similarly, in the patients' perception, the non-gatekeeping GPs dealt with these aspects more often. Patient characteristics (gender, age, education, psychosocial problems, bad health, depressive feelings, GPs' assessment of psychosocial background) showed many relationships. Of the GP characteristics, only the GPs' psychosocial diagnosis was associated with patient-reported psychosocial relevance and performance. Talking about biomedical issues was more important for the patients than talking about psychosocial issues, unless the patients presented psychosocial problems to the GP. Discrepancies between relevance and performance were apparent, especially with respect to biomedical aspects. The implications for health policy and for general practitioners are discussed.

Original languageEnglish (US)
Pages (from-to)115-127
Number of pages13
JournalPatient Education and Counseling
Issue number1
StatePublished - Jan 2000
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • General Medicine


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