Impact of Family Doctor Contract Services on Preventable Hospitalizations Amongst Patients with Hypertension in Rural China: Mediating Role of Primary Healthcare Quality

IF 2.7 4区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Risk Management and Healthcare Policy Pub Date : 2024-09-07 DOI:10.2147/rmhp.s474933

Wenyu Li, Yanqiu Hou, Jiayu An, Linxuan Chen, Shan Lu

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引用次数: 0

Abstract

Purpose: The objective of this study was to explore the connection between family doctor contract services and preventable hospitalizations. Additionally, we sought to examine the role of primary health care quality as a mediating factor in the link between family doctor contract services and preventable hospitalizations among patients with hypertension.
Patients and Methods: This cross-sectional study was performed in Dangyang (Hubei Province, Central China) and Xishui (Guizhou Province, Western China) counties in July–August 2023. Participants comprised 625 patients selected via a multi-stage sampling method. Causal mediation analysis was conducted to explore the effect of family doctor contract services on preventable hospitalizations and the mediating effect of primary healthcare quality on this relationship.
Results: Utilization rate of family doctor contract services of hypertensive patients was 58.6%, score of primary health service quality was 70.75 and incidence of preventable hospitalizations was 28.2%. Amongst hypertensive patients, utilization of family doctor contract services decreased the occurrence of preventable hospitalizations, with a total effect of − 0.22 (p < 0.001). Primary healthcare quality mediates the association, with a mediate effect of − 0.05 (p < 0.001), explaining 22.73% of the total effect.
Conclusion: Improving the utilization of family doctor contract services and primary healthcare quality may result in lower rates of preventable hospitalizations amongst hypertensive patients.

Keywords: family doctor contract services, preventable hospitalizations, primary healthcare quality, hypertension, mediation analysis

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家庭医生签约服务对中国农村高血压患者可预防性住院的影响：基层医疗质量的中介作用

目的：本研究旨在探讨家庭医生签约服务与可预防的住院治疗之间的关系。此外，我们还试图研究基层医疗卫生服务质量在家庭医生签约服务与高血压患者可预防性住院之间的中介作用：这项横断面研究于 2023 年 7 月至 8 月在当阳（湖北省，中国中部）和习水（贵州省，中国西部）两县进行。参与者包括通过多阶段抽样方法选出的 625 名患者。通过因果中介分析，探讨了家庭医生签约服务对可预防住院的影响，以及基层医疗质量对这一关系的中介效应：结果：高血压患者的家庭医生签约服务使用率为 58.6%，基层医疗卫生服务质量得分为 70.75，可预防的住院发生率为 28.2%。在高血压患者中，使用家庭医生签约服务降低了可预防住院的发生率，总效应为-0.22（p < 0.001）。基层医疗服务质量在其中起到了中介作用，中介效应为-0.05（p < 0.001），占总效应的 22.73%：关键词：家庭医生签约服务；可预防的住院；基层医疗质量；高血压；中介分析

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来源期刊

Risk Management and Healthcare Policy Medicine-Public Health, Environmental and Occupational Health

CiteScore

6.20

自引率

2.90%

发文量

242

审稿时长

16 weeks

期刊介绍： Risk Management and Healthcare Policy is an international, peer-reviewed, open access journal focusing on all aspects of public health, policy and preventative measures to promote good health and improve morbidity and mortality in the population. Specific topics covered in the journal include: Public and community health Policy and law Preventative and predictive healthcare Risk and hazard management Epidemiology, detection and screening Lifestyle and diet modification Vaccination and disease transmission/modification programs Health and safety and occupational health Healthcare services provision Health literacy and education Advertising and promotion of health issues Health economic evaluations and resource management Risk Management and Healthcare Policy focuses on human interventional and observational research. The journal welcomes submitted papers covering original research, clinical and epidemiological studies, reviews and evaluations, guidelines, expert opinion and commentary, and extended reports. Case reports will only be considered if they make a valuable and original contribution to the literature. The journal does not accept study protocols, animal-based or cell line-based studies.