Patient safety in family medicine through the eyes of people with chronic conditions in Slovenia

Grabar, Staša (author), Klemenc-Ketiš, Zalika (author)

Introduction Patient safety is a key dimension of healthcare quality, although most research has focused on hospital settings. This study analysed patient-reported experiences related to safety in Slovenian family medicine using data from the OECD PaRIS survey. Methods A cross-sectional study was conducted in 2023 among 70 family medicine practices in Slovenia. Data were collected using two validated questionnaires: the PaRIS Primary Care Patient Questionnaire (PaRIS-PQ) and the Primary Care Practice Questionnaire (PaRIS-PCPQ). Items Q69–Q75 of the PaRIS-PQ were analysed to assess experiences related to the use of medicines, medication review, repetition of information, adverse events, encouragement to express concerns, and barriers to care. Descriptive statistics, chi-square tests, correlation analysis, and binary logistic regression were used in data analysis. Results Respondents with chronic conditions totalled 2,133 (mean age 63.1 ± 10.9 years; 62.7% female). Polypharmacy (≥ 3 medications) occurred in 27% of respondents; only 19.7% had received a medication review in the previous 12 months. Seventeen percent reported experiencing at least one adverse event. Significant predictors of reported adverse events included repeated requests for personal medical information (p < 0.001), lack of encouragement to express concerns (p = 0.008), and transport barriers to accessing care (p = 0.024). The regression model explained a small proportion of the variance (Nagelkerke R² = 0.02). Conclusions Patient safety in Slovenian family medicine shows both strengths and areas requiring improvement. Communication processes, access barriers, and coordination of information appear to play an important role in perceived safety. Strengthening medication review practices and improving digital interoperability across healthcare settings may contribute to safer care in family medicine. Patient-reported measures such as PaRIS provide valuable insights for monitoring and improving patient safety in family medicine.

• Language: English
• Keywords: patient safety, family medicine, primary care, polypharmacy, communication, PaRIS, Slovenia
• Work type: Article
• Typology: 1.01 - Original Scientific Article
• Organization: MF - Faculty of Medicine
• Publication status: Published
• Publication version: Version of Record
• Year: 2026
• Number of pages: Str. 94-103
• Numbering: Letn. 65, iss. 2
• PID: 20.500.12556/RUL-185284
• UDC: 614
• ISSN on article: 0351-0026
• DOI: 10.2478/sjph-2026-0012
• COBISS.SI-ID: 279965187
• Publication date in RUL: 30.07.2026

Record is a part of a journal

• Title: Slovenian journal of public health
• Publisher: Zavod LRS za zdravstveno varstvo, Republiški zdravstveni center, Zavod LRS za zdravstveno varstvo, Republiški zdravstveni center, Nacionalni inštitut za javno zdravje, Inštitut za varovanje zdravja Republike Slovenije, Univerzitetni zavod za zdravstveno in socialno varstvo
• ISSN: 0351-0026
• COBISS.SI-ID: 3287810

Licences

• License: CC BY 4.0, Creative Commons Attribution 4.0 International
• Link: http://creativecommons.org/licenses/by/4.0/
• Description: This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

Secondary language

• Language: Slovenian
• Title: Varnost bolnikov v družinski medicini - pogled bolnika

Abstract

Uvod Varnost bolnikov je ključna razsežnost kakovosti zdravstvene oskrbe, vendar se je večina dosedanjih raziskav osredotočala predvsem na bolnišnično okolje. Ta raziskava analizira izkušnje bolnikov, povezane z varnostjo v slovenski družinski medicini, na podlagi podatkov raziskave OECD PaRIS. Metode Leta 2023 je bila izvedena presečna raziskava v 70 ambulantah družinske medicine v Sloveniji. Podatki so bili zbrani z dvema validiranima vprašalnikoma: PaRIS vprašalnikom za bolnike v primarnem zdravstvu (PaRIS-PQ) in vprašalnikom za ambulante primarnega zdravstva (PaRIS-PCPQ). Za analizo so bila uporabljena vprašanja Q69–Q75 iz vprašalnika PaRIS-PQ, ki obravnavajo uporabo zdravil, pregled terapije, ponavljanje zdravstvenih informacij, neželene dogodke, spodbujanje bolnikov k izražanju skrbi ter ovire pri dostopu do zdravstvene oskrbe. Podatki so bili analizirani z deskriptivno statistiko, hi-kvadrat testom, korelacijsko analizo in binarno logistično regresijo. Rezultati V raziskavo je bilo vključenih 2133 pacientov s kroničnimi boleznimi (povprečna starost 63,1 ± 10,9 let; 62,7 % žensk). Polifarmacija (≥ 3 zdravila) je bila prisotna pri 27 % anketirancev, medtem ko je le 19,7 % bolnikov poročalo o opravljenem pregledu terapije v zadnjih 12 mesecih. Sedemnajst odstotkov bolnikov je poročalo o vsaj enem neželenem dogodku. Pomembni napovedniki poročanih neželenih dogodkov so bili ponavljajoče zahteve po posredovanju osebnih zdravstvenih informacij (p < 0,001), pomanjkanje spodbujanja bolnikov k izražanju skrbi (p = 0,008) ter transportne ovire pri dostopu do zdravstvene oskrbe (p = 0,024). Regresijski model je pojasnil majhen delež variance (Nagelkerke R² = 0,02). Zaključki Varnost bolnikov v slovenski družinski medicini kaže tako prednosti kot tudi področja, ki zahtevajo izboljšave. Komunikacijski procesi, ovire pri dostopu do zdravstvene oskrbe ter usklajevanje informacij imajo pomembno vlogo pri zaznani varnosti. Krepitev sistematičnega pregleda terapije in izboljšanje digitalne interoperabilnosti med zdravstvenimi sistemi bi lahko prispevala k večji varnosti v primarnem zdravstvu. Bolnikom poročani kazalniki, kot je raziskava PaRIS, ponujajo pomemben vpogled v spremljanje in izboljševanje kakovosti in varnosti v družinski medicini.

• Keywords: varnost bolnikov, družinska medicina, primarno zdravstveno varstvo, polifarmacija, komunikacija, Slovenija

Projects

• Funder: ARIS - Slovenian Research and Innovation Agency
• Project number: V3-2102
• Name: Ocena izkušenj in izidov zdravstvene oskrbe pacientov s kroničnimi nenalezljivimi boleznimi v ambulantah družinske medicine v Sloveniji

• Funder: Ministrstvo za zdravje RS