初级卫生保健组织模式下患者对慢性病护理评估的差异：一项多层次队列分析。
Variations in patients' assessment of chronic illness care across organizational models of primary health care: a multilevel cohort analysis.
作者信息
Lévesque Jean-Frédéric, Feldman Debbie Ehrmann, Lemieux Valérie, Tourigny André, Lavoie Jean-Pierre, Tousignant Pierre
机构信息
Scientific Director, Institut National de Santé Publique du Québec, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, QC.
出版信息
Healthc Policy. 2012 Nov;8(2):e108-23.
Abstract
PURPOSE
To measure patients' assessment of chronic illness care and its variation across primary healthcare (PHC) models.
METHODS
We recruited 776 patients with diabetes, heart failure, arthritis or chronic obstructive pulmonary disease from 33 PHC clinics. Face-to-face interviews, followed by a telephone interview at 12 months, were conducted using the Patient Assessment of Chronic Illness Care (PACIC). Multilevel regression was used in the analysis.
RESULTS
The mean PACIC score was low at 2.5 on a scale of 1 to 5. PACIC scores were highest among patients affiliated with family medicine groups (mean, 2.78) and lowest for contact models (mean, 2.35). Patients with arthritis and older persons generally reported a lower assessment of chronic care.
CONCLUSION
Family medicine groups represent an integrated model of PHC associated with higher levels of achievement in chronic care. Variations across PHC organizations suggest that some models are more appropriate for improving management of chronic illness.
摘要
目的
评估患者对慢性病护理的评价及其在初级卫生保健（PHC）模式中的差异。
方法
我们从33家初级卫生保健诊所招募了776名患有糖尿病、心力衰竭、关节炎或慢性阻塞性肺疾病的患者。采用慢性病护理患者评估（PACIC）工具进行面对面访谈，随后在12个月时进行电话访谈。分析采用多水平回归。
结果
PACIC评分平均较低，在1至5分的量表上为2.5分。在隶属于家庭医学组的患者中，PACIC评分最高（平均2.78分），而接触模式的患者评分最低（平均2.35分）。患有关节炎的患者和老年人对慢性病护理的评价普遍较低。
结论
家庭医学组代表了一种初级卫生保健的综合模式，与慢性病护理方面更高的成就水平相关。初级卫生保健组织之间的差异表明，某些模式更适合改善慢性病管理
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