Table 5.
Summary of main categories and subcategories of perceived problems in ambulatory care
| No | Main category | Rural areas | Environs | Urban areas | |||
|---|---|---|---|---|---|---|---|
| Subcategory | GP | Pat | GP | Pat | GP | Pat | |
| 1 | Problems due to demographic change | ||||||
| Aging patients and GPs | X | X | X | X | X | ||
| Lack of young recruits in primary care | X | X | X | X | |||
| 2 | Problems due to patient behaviour | ||||||
| Certain patient types are very time consuming | X | X | X | X | X | ||
| Patients misjudge the necessity of treatment and consult their GPs too late | X | X | X | X | |||
| Patients misjudge the necessity treatment and consult their GPs about banalities | X | X | |||||
| Urban patients have less confidence in their GP’s abilities | X | X | X | ||||
| 3 | Problems through structural inequalities | ||||||
| Not enough GPs in rural areas lead to long waiting times and crowded practices | X | X | X | X | |||
| The work-life balance of the GP is threatened by long working hours | X | X | X | X | |||
| (Too) many GPs in urban areas lead to high competition rates and to the poaching of patients | X | ||||||
| (Too) many GPs in urban areas lead to a higher fluctuation of patients | X | X | |||||
| A lack of parking spots leads to long commutes in urban areas (for GPs and patients) | X | X | |||||
| Long distances lead to long commutes in rural areas (for GPs and patients) | X | X | X | X | |||
| 4 | Problems through the ambulatory compensation system | ||||||
| GPs’ budgets are not adequate | X | X | X | X | X | ||
| Some consultations are not financially compensated for GPs | X | X | X | ||||
| 5 | Problems with specialist care | ||||||
| A lack of specialists leads to long waits for appointments | X | X | X | X | X | X | |
| GPs have to assume duties of the specialists | X | X | X | X | |||
| Specialists do not inform or inadequately inform their patients’ GPs | X | X | |||||
| 6 | Problems with inpatient care | ||||||
| GPs must provide follow-up care for patients discharged with still healing wounds | X | X | X | ||||
| Staff shortage in hospitals in rural areas | X | X | |||||
| Lack of cooperation/communication between GPs and hospitals | X | X | X | ||||
| Discharge reports are incorrect or missing | X | X | X | ||||
| Prescribed medications from hospitals must be reduced by the GP on an outpatient basis | X | X | |||||
| GPs and patients consider some hospital therapies/diagnostics unnecessary | X | X | X | ||||
X = problems mentioned by interviewees in the respective area