中国患者感知的基础医疗质量与自我报告的医院使用率之间的关系:一项横断面研究。

IF 2.3 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
European Journal of General Practice Pub Date : 2024-12-01 Epub Date: 2024-02-26 DOI:10.1080/13814788.2024.2308740
Chenwen Zhong, Junjie Huang, Lina Li, Zhuojun Luo, Cuiying Liang, Mengping Zhou, Nan Hu, Li Kuang
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引用次数: 0

摘要

背景:减少可避免的入院治疗是全球医疗保健的首要任务,而最佳的初级医疗服务被认为是实现这一目标的关键。然而,在中国这样的发展中经济体制下,初级医疗在没有强制把关的情况下不断发展,患者感知的初级医疗质量与医院使用率之间的关系仍未得到充分探讨:本研究旨在探讨中国患者感知的初级医疗质量与自我报告的医院使用率之间的关系:方法:从16个基层医疗机构收集数据。方法:从 16 个基层医疗机构收集数据,采用 "基层医疗质量评估调查 "量表测量患者感知的基层医疗质量,包括六个方面(首次接触医疗、连续性、全面性、可及性、协调性和以患者为中心)。医院使用情况包括患者自我报告的最近六个月的门诊就诊、入院和急诊室就诊情况。在对潜在的混杂因素进行调整后,对自我报告的医院使用情况与感知的初级医疗质量之间的关系进行了逻辑回归分析:在招募的 1,185 名患者中,有 398 人(33.6%)报告了医院使用情况。逻辑回归分析表明,患者感知的初级医疗质量总分越高,住院率(调整后的几率比(AOR):0.417,95% 置信区间(CI):0.308-0.565)、门诊就诊率(AOR:0.394,95% 置信区间(CI):0.275-0.566)和入院率(AOR:0.496,95% 置信区间(CI):0.276-0.891)就越低。然而,医疗服务的连续性与急诊室就诊率呈正相关(AOR:2.252,95% CI:1.051-4.825):结论:在中国,患者感知到的基层医疗质量的提高与自我报告的总体医院使用率(包括门诊就诊和住院)的降低有关。然而,更好的持续性医疗服务可能与急诊室就诊次数的增加有关。要准确了解和验证这些发现,还需要进一步的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Relationship between patient-perceived quality of primary care and self-reported hospital utilisation in China: A cross-sectional study.

Background: Reducing avoidable hospital admissions is a global healthcare priority, with optimal primary care recognised as pivotal for achieving this objective. However, in developing systems like China, where primary care is evolving without compulsory gatekeeping, the relationship between patient-perceived primary care quality and hospital utilisation remains underexplored.

Objectives: This study aimed to explore the association between patient-perceived primary care quality and self-reported hospital utilisation in China.

Methods: Data were collected from 16 primary care settings. Patient-perceived quality of primary care was measured using the Assessment Survey of Primary Care scale across six domains (first-contact care, continuity, comprehensiveness, accessibility, coordination, and patient-centredness). Hospital utilisation included patient self-reported outpatient visits, hospital admissions, and emergency department (ED) visits in the last six months. Logistic regression analyses were examined associations between self-reported hospital utilisation and perceived primary care quality adjusted for potential confounders.

Results: Of 1,185 patients recruited, 398 (33.6%) reported hospital utilisation. Logistic regression analyses showed that higher total scores for patient-perceived quality of primary care were associated with decreased odds of hospital utilisation (adjusted odds ratio(AOR): 0.417, 95% confidence interval (CI): 0.308-0.565), outpatient visits (AOR: 0.394, 95% CI: 0.275-0.566) and hospital admissions (AOR: 0.496, 95% CI: 0.276-0.891). However, continuity of care was positively associated with ED visits (AOR: 2.252, 95% CI: 1.051-4.825).

Conclusion: Enhanced patient-perceived quality of primary care in China is associated with a reduction in self-reported overall hospital utilisation, including outpatient visits and hospital admissions. However, better continuity of care may be associated with increased ED visits. Further research is warranted for precise insights and validation of these findings.

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来源期刊
European Journal of General Practice
European Journal of General Practice PRIMARY HEALTH CARE-MEDICINE, GENERAL & INTERNAL
CiteScore
5.10
自引率
5.90%
发文量
31
审稿时长
>12 weeks
期刊介绍: The EJGP aims to: foster scientific research in primary care medicine (family medicine, general practice) in Europe stimulate education and debate, relevant for the development of primary care medicine in Europe. Scope The EJGP publishes original research papers, review articles and clinical case reports on all aspects of primary care medicine (family medicine, general practice), providing new knowledge on medical decision-making, healthcare delivery, medical education, and research methodology. Areas covered include primary care epidemiology, prevention, diagnosis, pharmacotherapy, non-drug interventions, multi- and comorbidity, palliative care, shared decision making, inter-professional collaboration, quality and safety, training and teaching, and quantitative and qualitative research methods.
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