Regular Doctor

  • 文章类型: Journal Article
    背景:通常的护理来源(USC)与纵向和个性化服务有关,这是初级保健的属性。以患者为中心的沟通,以病人为中心的护理的一个重要元素,帮助医生从病人的角度理解健康问题。我们分析了南加州大学与以患者为中心的沟通之间的关联。
    方法:分析使用了韩国卫生小组2018年的数据。通过结合四个与沟通相关的问卷项目获得以患者为中心的沟通得分。通常的护理来源类型是根据对两个问卷项目的回答进行分类的:没有南加州大学,一个没有正规医生和正规医生的地方。多元logistic回归分析用于校正混杂因素。
    结果:有正规医生的人(71.8%)的良好沟通率高于没有南加州大学的人(61.8%)或只有一个地方的人(61.5%)。那些有正规医生的人有更好的沟通(赔率比,1.49对于健康状况较差/中度的个人,对于健康状况良好的人和2.08)比那些在调整混杂因素后没有南加州大学的人。在沟通方面,在没有南加州大学的个体和只有一个地方的个体之间没有观察到差异.
    结论:有一个正规的医生可以促进患者和医生之间的沟通。良好的沟通可能是有一个普通医生和相关的有益结果之间的中介。通过有一个普通的医生更好的沟通,以及先前研究中发现的其他一些好处表明,需要制定一项鼓励个人定期医生的健康政策。
    BACKGROUND: A usual source of care (USC) is related to longitudinal and personalized services, which are attributes of primary care. Patient-centered communication, an important element of patient-centered care, helps physicians understand health problems from a patient\'s point of view. We analyzed the association between USC and patient-centered communication.
    METHODS: Data from the Korea Health Panel 2018 were used in the analysis. Patient-centered communication scores were obtained by combining the four communication-related questionnaire items. Usual source of care types were categorized based on responses to two questionnaire items: no USC, a place without a regular doctor and with a regular doctor. Multiple logistic regression analysis was used to adjust for confounders.
    RESULTS: Good communication rate was higher for those with a regular doctor (71.8%) than for those with no USC (61.8%) or a place only (61.5%). Those with a regular doctor had better communication (odds ratio, 1.49 for individuals with poor/moderate health, and 2.08 for those with good health) than those without a USC after adjusting for confounders. In terms of communication, no difference was observed between individuals with no USC and those with a place only.
    CONCLUSIONS: Having a regular doctor promotes communication between patients and doctors. Good communication may be a mediator between having a regular doctor and related beneficial outcomes. Better communication by having a regular doctor, along with several other benefits identified in previous studies suggests the need for a health policy that encourages individuals to have regular doctors.
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  • 文章类型: Journal Article
    移民加拿大面临独特的医疗保健障碍,这导致了医疗保健利用的不平等。加拿大移民对医疗保健的利用率较低与移民个人健康状况恶化以及医疗保健系统成本增加有关。现有文献表明,移民以来的时间是加拿大移民利用医疗保健的重要预测因素;但是,很少有研究在他们的分析中包括这个变量。这项研究旨在研究自移民以来拥有正规医疗保健提供者与时间之间的关系,以及自移民以来过去一年和时间的医疗咨询数量。
    使用Andersen和Newman的卫生服务利用框架和来自2015-2016年加拿大社区健康调查(CCHS)的数据进行了二级横截面数据分析,以检查加拿大移民的医疗保健利用情况。我们使用多元逻辑回归来检查自移民以来的时间与有常规医生和负二项回归之间的关系,以比较最近(自移民以来不到10年)和已建立(自移民以来10年或更长时间)移民的咨询次数。
    2015-2016年的CCHS移民受访者中,有84%有正规的医疗保健提供者。在控制其他独立变量后,与最近的移民相比,已建立的移民拥有正规医疗保健提供者的可能性是1.75倍(95%置信区间:1.45-2.10)。前一年,移民的医疗咨询平均为3.37(标准偏差4.53)。最近和已建立的移民的平均医疗咨询次数没有差异。
    控制其他独立变量后,这项研究发现,自移民以来的时间对拥有正规医疗服务提供者有显著影响,但对咨询次数没有影响。在这项研究中观察到的最近和已建立的移民在医疗保健利用方面的差异可能部分归因于加拿大不断发展的移民政策以及移民随着时间的推移的经济和社会融合。
    Immigrants to Canada face unique barriers to health care, which leads to inequities in health care utilization. Lower utilization of health care by immigrants to Canada is associated with the deteriorating health of individual immigrants as well as increased costs to the health care system. The existing literature suggests that time since immigration is an important predictor for utilization of health care for Canadian immigrants; however, few studies have included this variable in their analysis. This study aims to examine the relationships between having a regular health care provider and time since immigration, and number of medical consultations in the past year and time since immigration.
    A secondary cross-sectional data analysis using Andersen and Newman\'s Framework of Health Service Utilization and data from the 2015-2016 Canadian Community Health Survey (CCHS) was conducted to examine health care utilization among immigrants in Canada. We used multiple logistic regression to examine the relationship between time since immigration and having a regular physician and negative binomial regression to compare the number of consultations of recent (less than 10 years since immigration) and established (10 or more years since immigration) immigrants.
    Eighty four percent of immigrant respondents to CCHS 2015-2016 had a regular health care provider. After controlling for other independent variables, established immigrants were 1.75 (95% confidence interval: 1.45-2.10) times more likely to have a regular health care provider compared to recent immigrants. Immigrants had a mean of 3.37 (standard deviation 4.53) medical consultations in the preceding year. There was no difference in the mean number of medical consultations by recent and established immigrants.
    After controlling for other independent variables, this study found that time since immigration had a significant effect on having a regular provider but not on number of consultations. Differences in health care utilization for recent and for established immigrants observed in this study may be partially explained by Canada\'s evolving immigration policy and the economic and social integration of immigrants over time.
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