Rural-urban differences in determinants of patient satisfaction with primary care

Weinhold, Ines; Gurtner, Sebastian (2018). Rural-urban differences in determinants of patient satisfaction with primary care Social science & medicine, 212, pp. 76-85. Elsevier Ltd 10.1016/j.socscimed.2018.06.019

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In light of the rising regional inequalities in primary care provider supply, to ensure equitable access is a pressing issue in health policy. Most policy approaches fall short in considering the patient perspective when defining shortage areas. As a consequence, implementations of new service delivery models might fail to be responsive to patients' expectations. To explore regional differences in the relative importance of structure and process attributes as drivers of patient satisfaction with local primary care, we collected data from residents of three objectively well-supplied urban and six objectively worse-supplied rural areas in Germany and tested a multi-group structural equation model. The results suggest that the relative importance of care attributes is different among the regional conditions rural and urban. Regardless of regional constraints, the strongest determinants of satisfaction are not related to structural aspects but are concerned with the quality of the doctor-patient relationship. A lack of available choices and a higher tolerance in terms of distances provide possible explanations for the results. The high importance rural residents attribute to the interpersonal relation should not be neglected in the re-organization of traditional service delivery in rural areas.

Item Type:

Journal Article (Original Article)


Business School > Institute for Innovation and Strategic Entrepreneurship > Low-end Innovation
Business School


Weinhold, Ines and
Gurtner, Sebastian


Elsevier Ltd




Service Account

Date Deposited:

09 Aug 2019 14:00

Last Modified:

09 Aug 2019 14:00

Publisher DOI:


Uncontrolled Keywords:

Patient perspective; Primary care evaluation; Rural health care; Structural equation model




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