Goetz Katja, Szecsenyi Joachim, Laux Gunter, Joos Stefanie, Beyer Martin, Miksch Antje
Abteilung Allgemeinmedizin und Versorgungsforschung, Universitätsklinikum Heidelberg.
Z Evid Fortbild Qual Gesundhwes. 2013;107(6):379-85. doi: 10.1016/j.zefq.2013.06.001. Epub 2013 Jul 16.
Considering the demographic development models for primary care have to be focused on chronic illness care especially. The so called "Hausarztzentrierte Versorgung" (HzV) in Baden-Wuerttemberg constitutes such a model of an implementation of family doctor-centred health care. For evaluation purposes the perspective of patients is of particular interest. Therefore the aim of this study was to analyse how chronically ill patients assess their medical care. Altogether 53 primary care practices in Baden-Wuerttemberg took part in a patient survey. The quality of chronic illness care from the patients' perspective was assessed by means of the PACIC short form. Furthermore the general satisfaction with care as well as sociodemographic characteristics were determined. For analysis two different groups were regarded: HzV-doctor and HzV-patient with a chronic condition (group 1) and non-HzV-doctor and non-HzV-patient with a chronic condition (group 2). Altogether 2,535 patients were recruited for the survey (response rate 47.8%). Out of these, 836 patients could be assigned to group 1 and 319 patients could be assigned to group 2. Patients in both groups were very satisfied with their care. The patients in group 1 stated more frequently that they received a written treatment plan from their general practitioner and that they were asked about their state of health when leaving the practice. Overall satisfaction was positively associated with organisation of care (β= 0.484), support in difficult situations (β= 0.171) and information on the usefulness of consulting other doctors (β= 0.163) with an explained variation of R(2)=0.459. Irrespective of their group affiliation patients rate the medical care of their chronic condition very positively. Especially the assessment of the quality of care from the perspective of different patient groups (HzV participants and non-HzV participants) could contribute essentially as a feedback for physicians concerning the implementation of the main contents of the HzV for participating physicians.
考虑到初级保健的人口发展模式必须特别关注慢性病护理。巴登-符腾堡州所谓的“家庭医生中心式护理”（HzV）构成了这样一种以家庭医生为中心的医疗保健实施模式。出于评估目的，患者的视角尤为重要。因此，本研究的目的是分析慢性病患者如何评价他们的医疗护理。巴登-符腾堡州共有53家初级保健机构参与了一项患者调查。通过PACIC简表从患者角度评估慢性病护理质量。此外，还确定了对护理的总体满意度以及社会人口学特征。为进行分析，将两组不同的人群纳入考虑：患有慢性病的HzV医生和HzV患者（第1组）以及患有慢性病的非HzV医生和非HzV患者（第2组）。总共招募了2535名患者参与调查（回复率47.8%）。其中，836名患者可归入第1组，319名患者可归入第2组。两组患者对他们的护理都非常满意。第1组的患者更频繁地表示他们从全科医生那里收到了书面治疗计划，并且在离开诊所时被询问了健康状况。总体满意度与护理组织（β=0.484）、困难情况下的支持（β=0.171）以及咨询其他医生的有用性信息（β=0.163）呈正相关，解释变异R(2)=0.459。无论所属组别如何，患者对其慢性病的医疗护理评价都非常积极。特别是从不同患者群体（HzV参与者和非HzV参与者）的角度对护理质量进行评估，对于参与的医生来说，可作为关于HzV主要内容实施情况的反馈，具有重要意义。
