Field K S, Briggs D J
University College Northampton, Park Campus, Boughton Green Road, Northampton NN2 7AL, UK.
Health Soc Care Community. 2001 Sep;9(5):294-308. doi: 10.1046/j.0966-0410.2001.00303.x.
Differences in levels of utilization vary and are a function of socio-economic and geographical factors. This paper presents the results of a questionnaire study involving twelve GP practices in Northamptonshire, UK, of factors which affect access and utilization in asthmatics and diabetics; these groups were selected to control for differences in utilization behaviour, as a result of different aetiologies. The questionnaire sought data on: residential location of patients, utilization characteristics of primary health-care, personal circumstances and mobility and hindrances to access and utilization. Key themes were identified relating to age, gender, social class, employment, ethnicity and proximity to the GP surgery. The young, elderly and females report higher rates of utilization, as do nonmanual workers and those who are unemployed. However, accessibility and utilization vary greatly in response to mobility and locational characteristics; these variations tend to be masked by data on overall rates of usage. Optimal scaling techniques were used to investigate the interactions between the factors affecting accessibility and utilization, and to characterize patients in terms of their levels of utilization. Results confirmed that current service provision afforded a differential level of service to patients, which does not directly reflect their level of need.
利用水平的差异各不相同，并且是社会经济和地理因素的函数。本文展示了一项问卷调查研究的结果，该研究涉及英国北安普敦郡的12家全科医生诊所，调查了影响哮喘患者和糖尿病患者就诊及利用医疗服务的因素；选择这两类人群是为了控制因病因不同而导致的利用行为差异。问卷旨在收集以下数据：患者的居住地点、初级医疗保健的利用特征、个人情况、流动性以及就诊和利用医疗服务的障碍。确定了与年龄、性别、社会阶层、就业、种族以及与全科医生诊所的距离相关的关键主题。年轻人、老年人和女性的利用率较高，非体力劳动者和失业者也是如此。然而，可及性和利用率会因流动性和地理位置特征而有很大差异；这些差异往往被总体使用率数据所掩盖。运用最优尺度技术来研究影响可及性和利用率的因素之间的相互作用，并根据患者的利用水平对其进行特征描述。结果证实，当前的服务提供给患者的服务水平存在差异，这并不能直接反映他们的需求水平。
