Better primary physician services lead to fewer hospital admissions.

The aim of the study was to examine whether improved quality of primary physician services, measured by patient satisfaction, leads to fewer admissions to somatic hospitals. We studied differences in hospital admissions at the municipality level in Norway. In addition to the standard explanatory variables for use of hospitals--gender, age, socio-economic status and travelling distance to the nearest hospital--we also included a measure of patient satisfaction with primary physician services in the municipality. Data on patient satisfaction was obtained from an extensive questionnaire survey of 63,798 respondents. We found a statistically significant negative relationship between patient satisfaction and the number of hospital admissions. This conclusion was robust with regard to the empirical specification, and the effect was large.