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Objective: To determine whether patient evaluations of the accessibility to general practice and co-ordination with other care providers were associated with characteristics of general practice organizations., Background: In 1998 patients across Europe perceived that small general practices have better accessibility than large practices. Since then a number of changes in primary care have had impact on accessibility and co-ordination of care., Design, Setting and Participants: The study was based on data from the European Practice Assessment study, an observational study in 284 general practices in 10 countries in 2004., Main Outcome Measures: Patient evaluations of general practice were measured with the 23-item Europep instrument, from which seven items on accessibility and co-ordination were selected in a principal factor analysis. Six practice characteristics were examined: percentage of female general practitioners, mean age of physicians, mean number of physician hours worked per week, number of general practitioners, number of care providers, urbanization level. Mixed regression models were applied, in which patients were clustered within practices, and practices within countries., Results: Practices with a higher numbers of care providers received less positive patient evaluations (b= -0.112, P=0.004). The other practice characteristics were not related to patient evaluations. Only a small proportion of the total variation in patient evaluations of accessibility and co-ordination (1.8%) was explained by characteristics of the general practice organizations., Conclusions: General practices have become larger in most developed countries in recent years, but patients seemed to prefer general practice organizations with fewer health professionals.

Objective: This study aimed to determine whether older patients' enablement was associated with their evaluation of the level of their involvement in primary care consultations., Methods: Secondary analysis of data from an international cross-sectional study in seven European countries (n=625 patients). Patient enablement, preference for involvement in the consultation and evaluation of involvement in the consultation were measured with validated questionnaires. Random coefficient linear modelling was used to identify factors associated with patient enablement., Results: The overall mean patient enablement score was 5.5 (theoretical range: 0-12; higher score indicated more enablement). Enablement was higher in patients who reported more positive compared to those reporting less positive evaluations of involvement (B=1.660; p<0.001). The impact of evaluation on enablement was higher in patients with a high preference for involvement compared to those with lower preference for involvement (B=0.743; p=0.015)., Conclusion: Positive evaluations of involvement in primary care were associated with higher enablement in older patients, and even more if the patient had a high preference for involvement., Practice Implications: Involving older patients actively may enhance their enablement, a particularly important goal for patients who have one or more chronic conditions.