Predictors of European general practitioners’ attitudes towards person-centered care across 24 countries: results from the PACE GP/FP study

Background Person-centeredness is a widely recognized key dimension of quality of care, but its implementation in primary care varies substantially. Understanding attitudes and challenges that support or hinder adoption is essential for effective integration. This paper explores general practitioners’/family physicians’ (GPs’) attitudes toward person-centered care (PCC) across 24 European countries and examines socio-demographic, professional, and work-related factors associated with these attitudes. Methods An online self-reported survey was conducted among GPs across Europe. Attitudes were assessed with the Patient-Practitioner Orientation Scale (PPOS), a validated instrument scored from 1 to 6 where higher scores reflect a more patient-centered orientation, including the Caring and Sharing sub-scales. Because GPs were nested within countries, linear mixed-effects (multilevel) models were used with country as a random effect and practitioner- and practice-level characteristics as fixed effects. The intraclass correlation coefficient (ICC) quantified between-country variation. Analyses used cleaned data from the 24 countries available as of December 12, 2024. Results In total, 3,691 GPs participated, and the mixed-model analysis of the PPOS total score included 3,370 respondents across 24 countries. Approximately 31% of the variance in PPOS total scores lay between countries (ICC = 0.31), indicating substantial cross-national variation. Regional grouping captured this variation better than EU integration status in descriptive comparisons; however, between-group variance was estimated from very few clusters and was therefore statistically unstable, thus exploratory. After adjustment, teaching involvement, specialist training in General Practice/Family Medicine, urban practice, an above-average share of psychiatrically vulnerable patients, and lower daily patient-contact volume were associated with higher (more patient-centered) scores, whereas higher perceived work-related stress, older age, and the least experience were associated with lower scores. Broadly similar patterns emerged for the Caring and Sharing sub-scales, with some dimensional differences. Conclusions In this pan-European study, individual, professional, and practice-level factors were associated with GPs’ attitudes toward PCC, and a substantial share of the variation was attributable to differences between countries. Given the cross-sectional design and that PPOS measures attitudes rather than delivered care, results should be interpreted as associations at the attitudinal level. Identifying these factors may support strategies to foster person-centered attitudes across diverse European primary care settings. Trial registration Not applicable.