■减少可避免的住院是全球医疗保健的优先事项,最佳初级保健被认为是实现这一目标的关键。然而,在开发像中国这样的系统时,初级保健在没有强制看门的情况下发展,患者感知的初级保健质量与医院利用率之间的关系仍未得到充分探索.
■本研究旨在探讨中国患者感知的初级保健质量与自我报告的医院利用率之间的关联。
■数据来自16个初级保健机构。患者感知的初级保健质量是使用初级保健评估调查量表在六个领域(首次接触护理,连续性,全面性,可访问性,协调,和以病人为中心)。医院利用率包括患者自我报告的门诊就诊,入院,和急诊科(ED)在过去六个月的访问。Logistic回归分析检查了自我报告的医院利用率与针对潜在混杂因素调整后的感知初级保健质量之间的关联。
■在招募的1,185名患者中,398(33.6%)报告了医院利用率。Logistic回归分析显示,患者感知的初级保健质量总分较高与医院利用率降低相关(调整比值比(AOR):0.417,95%置信区间(CI):0.308-0.565),门诊(AOR:0.394,95%CI:0.275-0.566)和住院(AOR:0.496,95%CI:0.276-0.891).然而,护理连续性与ED访视呈正相关(AOR:2.252,95%CI:1.051-4.825)。
■中国初级保健的患者感知质量的提高与自我报告的整体医院利用率的降低有关,包括门诊就诊和住院。然而,更好的护理连续性可能与增加急诊就诊有关.需要进一步的研究才能对这些发现进行精确的见解和验证。
在中国,提高患者感知的初级保健质量与降低自我报告的医院利用率有关,包括门诊就诊和住院。更好的初级保健可及性与自我报告的急诊科就诊和门诊就诊减少有关。护理连续性与急诊科就诊呈正相关,保证进一步的研究。
UNASSIGNED: 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.
UNASSIGNED: This study aimed to explore the association between patient-perceived primary care quality and self-reported hospital utilisation in
China.
UNASSIGNED: 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.
UNASSIGNED: 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).
UNASSIGNED: 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.
Improved patient-perceived primary care quality in
China was linked to lower self-reported hospital utilisation, including outpatient visits and hospital admissions.Better primary care accessibility was associated with decreased self-reported emergency department visits and outpatient visits.Continuity of care showed a positive association with emergency department visits, warranting further research.