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香港普通科门诊和私人全科诊所成年患者初级保健体验比较。

Comparison of primary care experiences among adults in general outpatient clinics and private general practice clinics in Hong Kong.

机构信息

School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, PR China.

出版信息

BMC Public Health. 2010 Jul 6;10:397. doi: 10.1186/1471-2458-10-397.

Abstract

BACKGROUND

The main goal of Hong Kong's publicly-funded general outpatient clinics (GOPCs) is to provide primary medical services for the financially vulnerable. The objective of the current study was to compare the primary care experiences of GOPC users and the users of care provided by private general practitioners (GPs) in Hong Kong via a territory-wide telephone survey.

METHODS

One thousand adults in Hong Kong aged 18 and above were interviewed by a telephone survey. The modified Chinese translated Primary Care Assessment Tool was used to collect data on respondents' primary care experience.

RESULTS

Our results indicated that services provided by GOPC were more often used by female, older, poorer, chronically-ill and less educated population. GOPC participants were also more likely to have visited a specialist or used specialist services (69.7% vs. 52.0%; p < 0.001), although this difference in utilization of specialist services disappeared after adjusting for age (55.7% vs. 52.0%, p = 0.198). Analyses were also performed to asses the relationship between healthcare settings (GOPCs versus private GPs) and primary care quality. Private GP patients achieved higher overall PCAT scores largely due to better accessibility (Mean: 6.88 vs. 8.41, p < 0.001) and person-focused care (Mean: 8.37 vs. 11.69, p < 0.001).

CONCLUSIONS

Our results showed that patients primarily receiving care from private GPs in Hong Kong reported better primary care experiences than those primarily receiving care from GOPCs. This was largely due to the greater accessibility and better interpersonal relationships offered by the private GPs. As most patients use both GOPCs and private GPs, their overall primary care experiences may not be as different as the findings of this study imply.

摘要

背景

香港政府资助的普通门诊(GOPC)的主要目标是为经济困难的人群提供基本医疗服务。本研究的目的是通过全港电话调查比较 GOPC 用户和香港私人全科医生(GP)的初级保健体验。

方法

通过电话调查,对 1000 名香港 18 岁及以上的成年人进行了采访。使用改良的中文翻译初级保健评估工具收集受访者初级保健体验的数据。

结果

我们的结果表明,GOPC 提供的服务更多地被女性、年龄较大、较贫困、慢性病和受教育程度较低的人群使用。GOPC 参与者也更有可能去看专科医生或使用专科服务(69.7%比 52.0%;p<0.001),尽管在调整年龄后,专科服务的利用差异消失(55.7%比 52.0%,p=0.198)。还进行了分析,以评估医疗保健环境(GOPC 与私人 GP)与初级保健质量之间的关系。私人 GP 患者的总体 PCAT 评分较高,主要是因为更好的可及性(平均值:6.88 比 8.41,p<0.001)和以人为中心的护理(平均值:8.37 比 11.69,p<0.001)。

结论

我们的结果表明,在香港主要从私人 GP 处接受治疗的患者报告的初级保健体验优于主要从 GOPC 处接受治疗的患者。这主要是由于私人 GP 提供了更大的可及性和更好的人际关系。由于大多数患者同时使用 GOPC 和私人 GP,他们的整体初级保健体验可能并不像本研究结果所暗示的那样不同。

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