SingHealth Centre for Health Services Research, Singapore Health Services Pte Ltd, 168 Jalan Bukit Merah, #06-08 Tower 3, Singapore.
Singapore Med J. 2012 Feb;53(2):109-15.
Patients in Singapore can choose their primary care provider on a per-episode basis and pay out-of-pocket for services rendered. The infrastructure of subsidised and private primary care sector facilities differs. Onsite ancillary services are available in subsidised facilities, allowing for convenience of routine investigations, while private clinics are usually standalone practices. This study sought to examine the factors influencing patients' choice of polyclinic.
This was a cross-sectional survey of a convenient sample of 484 random patients who sought treatment at a polyclinic located in a new housing estate from 24-27 June 2008.
The response rate was 85.4% (n = 409). 38.1% of the patients were male. Mean age was 36.2 years. Only 13.8% had a regular private family physician, while 37.3% were followed up at polyclinics. Patients on regular polyclinic follow-up were more likely to be older (p < 0.001), unemployed, retirees or housewives (p < 0.001) and were seeking treatment for chronic diseases (p < 0.001). Geographical convenience (p = 0.002), low cost of consultation (p = 0.024), and onsite laboratory (p = 0.001) and imaging services (p = 0.018) significantly influenced those on regular polyclinic follow-up to attend the polyclinic.
Affordability, convenience of travel and onsite laboratory facilities influence patients' choice of seeking treatment at polyclinics. Further research examining whether the overall convenience of onsite ancillary services influences patients' choice of primary care provider would be useful in redesigning private primary care infrastructure to enhance patient convenience and encourage more patients to have a regular private family physician.
新加坡的患者可以按次选择初级保健提供者,并自掏腰包支付服务费用。补贴和私人初级保健部门设施的基础设施不同。在补贴设施中提供现场辅助服务,方便进行常规检查,而私人诊所通常是独立的诊所。本研究旨在探讨影响患者选择综合诊疗所的因素。
这是对 2008 年 6 月 24 日至 27 日在一个新住房区内的一家综合诊疗所接受治疗的 484 名随机患者进行的横断面调查。
应答率为 85.4%(n=409)。38.1%的患者为男性。平均年龄为 36.2 岁。只有 13.8%的患者有固定的私人家庭医生,而 37.3%的患者在综合诊疗所接受治疗。定期到综合诊疗所就诊的患者年龄更大(p<0.001)、失业、退休或家庭主妇(p<0.001),且更有可能患有慢性病(p<0.001)。地理位置便利(p=0.002)、咨询费用低(p=0.024)、现场实验室(p=0.001)和影像服务(p=0.018)显著影响那些定期到综合诊疗所就诊的患者选择到该综合诊疗所就诊。
可负担性、旅行的便利性和现场实验室设施影响患者到综合诊疗所就诊的选择。进一步研究检查现场辅助服务的整体便利性是否影响患者对初级保健提供者的选择,将有助于重新设计私人初级保健基础设施,以提高患者的便利性,并鼓励更多患者有固定的私人家庭医生。