Hansen Anne Helen, Kristoffersen Agnete E, Lian Olaug S, Halvorsen Peder A
BMC Health Serv Res. 2014 Dec 10;14:629. doi: 10.1186/s12913-014-0629-7.
Continuity of general practitioner (GP) care is associated with reduced use of emergency departments, hospitalisation, and outpatient specialist services. Evidence about the relationship between continuity and use of complementary and alternative medical (CAM) providers has so far been lacking. The aim of this study was to test the association between continuity of GP care and the use of CAM providers.
We used questionnaire data from the sixth Tromsø Study, conducted in 2007-8. Using descriptive statistical methods, we estimated the proportion using a CAM provider among adults (30-87 years) who had visited a GP during the last 12 months. By means of logistic regressions, we studied the association between the duration of the GP-patient relationship and the use of CAM providers. Analyses were adjusted for the frequency of GP visits, gender, age, marital status, income, education, and self-rated health and other proxies for health care needs.
Of 9,743 eligible GP users, 85.1% had seen the same GP for more than two years, 83.7% among women and 86.9% among men. The probability of visiting a CAM provider was lower among those with a GP relationship of more than 2 years compared to those with a shorter GP relationship (odds ratio [OR] 0.81, 95% confidence interval [CI] 0.68-0.96). Other factors associated with CAM use were female gender, poor health, low age and high income. There was no association with education.
Continuity of GP care as measured by the duration of the GP-patient relationship was associated with lower use of CAM providers. Together with previous studies this suggests that continuity of GP care may contribute to health care delivery from fewer providers.
全科医生(GP)持续照护与减少急诊科就诊、住院以及门诊专科服务的使用相关。迄今为止,关于持续照护与补充和替代医学(CAM)提供者使用之间关系的证据尚不充分。本研究的目的是检验全科医生持续照护与CAM提供者使用之间的关联。
我们使用了2007 - 2008年进行的第六次特罗姆瑟研究的问卷数据。运用描述性统计方法,我们估算了在过去12个月内看过全科医生的成年人(30 - 87岁)中使用CAM提供者的比例。通过逻辑回归,我们研究了医患关系持续时间与CAM提供者使用之间的关联。分析针对全科医生就诊频率、性别、年龄、婚姻状况、收入、教育程度、自评健康状况以及其他医疗保健需求指标进行了调整。
在9743名符合条件的全科医生使用者中,85.1%的人看同一位全科医生超过两年,女性中这一比例为83.7%,男性中为86.9%。与全科医生关系超过两年的人群相比,与全科医生关系较短的人群使用CAM提供者的概率更低(优势比[OR] 0.81,95%置信区间[CI] 0.68 - 0.96)。与使用CAM相关的其他因素包括女性性别、健康状况差、年龄小和收入高。与教育程度无关。
以医患关系持续时间衡量的全科医生持续照护与CAM提供者的较低使用相关。与先前的研究一起表明,全科医生持续照护可能有助于减少医疗服务提供者的数量。