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Relationship between patient-perceived quality of primary care and self-reported hospital utilisation in China: A cross-sectional study.
Zhong, Chenwen; Huang, Junjie; Li, Lina; Luo, Zhuojun; Liang, Cuiying; Zhou, Mengping; Hu, Nan; Kuang, Li.
Afiliación
  • Zhong C; Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.
  • Huang J; Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
  • Li L; Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
  • Luo Z; Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.
  • Liang C; Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.
  • Zhou M; Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.
  • Hu N; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.
  • Kuang L; Department of Family and Preventive Medicine, and Population Health Sciences, University of UT School of Medicine, Salt Lake City, UT, USA.
Eur J Gen Pract ; 30(1): 2308740, 2024 Dec.
Article en En | MEDLINE | ID: mdl-38407121
ABSTRACT

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.
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Atención Primaria de Salud / Hospitales Límite: Humans País/Región como asunto: Asia Idioma: En Revista: Eur J Gen Pract Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Atención Primaria de Salud / Hospitales Límite: Humans País/Región como asunto: Asia Idioma: En Revista: Eur J Gen Pract Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido