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患者对韩国医疗机构结构类型的初级保健评估。

Patient's assessment of primary care of medical institutions in South Korea by structural type.

机构信息

Department of Family Medicine, College of Medicine, Catholic University, South Korea.

出版信息

Int J Qual Health Care. 2010 Dec;22(6):493-9. doi: 10.1093/intqhc/mzq053. Epub 2010 Oct 8.

DOI:10.1093/intqhc/mzq053
PMID:20935007
Abstract

OBJECTIVE

To compare patient's assessment of primary care of medical institutions by structural type.

DESIGN

Cross-sectional study.

SETTING

Primary care clinics where family physicians work in South Korea (nine private clinics, three health cooperative clinics, three public health center clinics and five teaching hospital clinics). We collected data by questionnaire survey from April 2007 to June 2007.

PARTICIPANTS

Study subjects were patients who had visited their primary care clinic on six or more occasions over a period of more than 6 months as a usual source of care.

MAIN OUTCOME MEASURES

Scores in each domain of primary care, evaluated by the Korean Primary Care Assessment Tool.

RESULTS

A total of 968 subjects were surveyed. The median of primary care average scores was the highest (78) in health cooperative clinics, the second in teaching hospitals clinics, the third in private clinics and the lowest (62) in public health center clinics. When compared with private clinics, the odds ratio for having a high primary care average score was 2.1 (95% confidence interval 1.3-3.3) for health cooperative clinics, and 0.55 (95% confidence interval 0.34-0.88) for public health center clinics.

CONCLUSION

Among medical institutions where family physicians work in South Korea, health cooperative clinics showed the highest primary care average score, and public health center clinics the lowest. To reinforce primary care in South Korea, where medical service delivery systems are only loosely established, health cooperative clinics could serve as an alternative.

摘要

目的

比较医疗机构结构类型对患者初级保健评估的影响。

设计

横断面研究。

地点

韩国家庭医生工作的初级保健诊所(9 家私人诊所、3 家健康合作社诊所、3 家公共卫生中心诊所和 5 家教学医院诊所)。我们于 2007 年 4 月至 6 月通过问卷调查收集数据。

参与者

研究对象为作为常规就诊来源、6 个月以上、就诊次数超过 6 次的患者。

主要观察指标

使用韩国初级保健评估工具评估的初级保健各领域的评分。

结果

共调查了 968 名患者。初级保健平均评分中位数最高的是健康合作社诊所(78),其次是教学医院诊所(74)、第三是私人诊所(69),最低的是公共卫生中心诊所(62)。与私人诊所相比,健康合作社诊所具有较高初级保健平均评分的优势比为 2.1(95%置信区间 1.3-3.3),公共卫生中心诊所为 0.55(95%置信区间 0.34-0.88)。

结论

在韩国开展家庭医生服务的医疗机构中,健康合作社诊所的初级保健平均评分最高,公共卫生中心诊所最低。在韩国,医疗服务提供系统仅初步建立,为加强初级保健,健康合作社诊所有望成为一种替代选择。

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