Family Doctors’ Perception of Patient Safety Issues in Rural Versus Urban Primary Healthcare Facilities

Background: The Republic of Moldova is an Eastern European country with the capital in Chisinau and 2,5 million inhabitants (57% rural areas). Aim: To identify differences between rural, urban and Chisinau family doctors’ perception of patient safety culture and to benchmark the results. Methods: This cross-sectional study is based on 776 responses gathered with the AHRQ MOSOPSC in 2020. Percent of positive responses (PPRs) by item and administrative area were analyzed and benchmarked against other countries. Results: PPRs based on responses from Chisinau (45%), rural (33%) and urban (22%) primary healthcare facilities (PHFs) were ? 75% for 80% items and ?50% for tree items: rush when taking care of patients, high ratio patient/personnel, inadequate capacity to handle everything effectively. Five items in urban areas had PPRs significantly lower than in the other areas: exchanging accurate, complete and timely information with hospitals (70%); level of disorganization in the office (64%); workflow problems in the office (60%), difficulty to voice disagreement (56%), insufficient staff to handle the patient load (36%). Conclusion: Significant differences were only found in urban PHFs. High shortage of resources in rural areas and free choice of family doctors by rural residents increase affluence to urban or Chisinau PHFs. Urban PHFs have less resources to cope with patient number and workflow than Chisinau and this is likely to lead to significant differences in the family doctors’ perception of patient safety culture.