Section of General Practice and Primary Care, Division of Community-based Sciences, Faculty of Medicine, University of Glasgow, UK.
BMC Fam Pract. 2010 Jun 4;11:46. doi: 10.1186/1471-2296-11-46.
Primary care based management of long-term conditions (LTCs) is high on the international healthcare agenda, including the Asia-Pacific region. Hong Kong has a 'mixed economy' healthcare system with both public and private sectors with a range of types of primary care doctors. Recent Hong Kong Government policy aims to enhance the management of LTCs in primary care possibly based on a 'family doctor' model. Patients' views on this are not well documented and the aim of the present study was to explore the views of patients with LTCs on family doctors in Hong Kong.
The views of patients (with a variety of LTCs) on family doctors in Hong Kong were explored. Two groups of participants were interviewed; a) those who considered themselves as having a family doctor, b) those who considered themselves as not having a family doctor (either with a regular primary care doctor but not a family doctor or with no regular primary care doctor). In-depth individual semi-structured interviews were carried out with 28 participants (10 with a family doctor, 10 with a regular doctor, and 8 with no regular doctor) and analysed using the constant comparative method.
Participants who did not have a family doctor were familiar with the concept but regarded it as a 'luxury item' for the rich within the private healthcare system. Those with a regular family doctor (all private) regarded having one as important to their and their family's health. Participants in both groups felt that as well as the more usual family medicine specialist or general practitioner, traditional Chinese medicine practitioners also had the potential to be family doctors. However most participants attended the public healthcare system for management of their LTCs whether they had a family doctor or not. Cost, perceived need, quality, trust, and choice were all barriers to the use of family doctors for the management of their LTCs.
Important barriers to the adoption of a 'family doctor' model of management of LTCs exist in Hong Kong. Effective policy implementation seems unlikely unless these complex barriers are addressed.
长期病的基层医疗管理（LTCs）在国际医疗保健议程中非常重要，包括亚太地区。香港有一个“混合经济”医疗保健系统，包括公共和私营部门，以及各种类型的基层医疗医生。香港政府最近的政策旨在加强基层医疗保健对长期病的管理，可能基于“家庭医生”模式。患者对此的看法并没有得到很好的记录，本研究的目的是探讨香港长期病患者对家庭医生的看法。
探讨了香港患者（患有各种 LTCs）对家庭医生的看法。采访了两组参与者：a）那些认为自己有家庭医生的人，b）那些认为自己没有家庭医生的人（要么有定期的基层医疗医生但不是家庭医生，要么没有定期的基层医疗医生）。对 28 名参与者（10 名有家庭医生，10 名有定期医生，8 名没有定期医生）进行了深入的个人半结构化访谈，并使用恒定性比较方法进行了分析。
没有家庭医生的参与者熟悉这个概念，但认为这是私人医疗保健系统中富人的“奢侈品”。那些有定期家庭医生（全部是私人的）认为有一个家庭医生对他们和他们家庭的健康很重要。两组参与者都认为，除了常见的家庭医学专家或全科医生外，传统中医从业者也有可能成为家庭医生。然而，大多数参与者无论是否有家庭医生，都在公立医院系统中管理他们的 LTCs。成本、感知需求、质量、信任和选择都是管理 LTCs 时使用家庭医生的障碍。
在香港，采用“家庭医生”模式管理 LTCs 存在重要障碍。除非解决这些复杂的障碍，否则有效的政策实施似乎不太可能。
