有家庭医生与初级保健咨询中一些更好的患者报告结局相关。
Having a Family Doctor is Associated with Some Better Patient-Reported Outcomes of Primary Care Consultations.
机构信息
Department of Family Medicine and Primary Care, The University of Hong Kong , Hong Kong , China.
Section of General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow , Glasgow , UK.
出版信息
Front Med (Lausanne). 2014 Sep 15;1:29. doi: 10.3389/fmed.2014.00029. eCollection 2014.
BACKGROUND
Hong Kong (HK) has pluralistic primary care that is provided by a variety of doctors. The aim of our study was to assess patient-reported outcomes of primary care consultations in HK and whether having a family doctor (FD) made any difference.
METHODS
We interviewed by telephone 3148 subjects from 5174 contacted households (response rate 60.8%) randomly selected from the general population of HK about the experience of their last primary care consultations in September 2007 and April 2008. We compared the patient-reported outcomes (PRO) and patient-centered process of care in those with a FD, those with other types of regular primary care doctors (ORD) and those without any regular primary care doctor (NRD). PRO included patient enablement, global improvement in health, overall satisfaction, and likelihood of recommending their doctors to family and friends. Patient-centered process of care indicators was explanations about the illness, and address of patient's concerns.
RESULTS
One thousand one hundred fifty, 746, and 1157 reported to have FD, ORD, and NRD, respectively. Over 80% of those with FD consulted their usual primary care doctors in the last consultation compared with 27% of those with NRD. Compared with subjects having ORD or NRD, subjects with FD reported being more enabled after the consultation and were more likely to recommend their doctors to family and friends. Subjects with FD and ORD were more likely than those having NRD to report a global improvement in health and satisfaction. FD group was more likely than the other two groups to report receiving an explanation on the diagnosis, nature, and expected course of the illness, and having their concerns addressed. Patient enablement was associated with explanation of diagnosis, nature, and expected course of illness, and address of patient's concerns.
CONCLUSION
People with a regular FD were more likely to feel being enabled and to experience patient-centered care in consultations.
背景
香港（HK）拥有多元化的基层医疗服务，由各种医生提供。我们的研究目的是评估香港基层医疗咨询的患者报告结果，以及是否有家庭医生（FD）会产生影响。
方法
我们于 2007 年 9 月和 2008 年 4 月，通过电话随机访问了从 HK 普通人群中联系的 5174 户家庭中的 3148 名受访者（回应率为 60.8%），了解他们最近一次基层医疗咨询的经历。我们比较了有 FD、其他类型的常规初级保健医生（ORD）和没有任何常规初级保健医生（NRD）的患者报告结果（PRO）和以患者为中心的护理过程。PRO 包括患者赋权、健康整体改善、总体满意度以及向家人和朋友推荐医生的可能性。以患者为中心的护理过程指标包括对疾病的解释以及对患者关注问题的处理。
结果
分别有 1150、746 和 1157 人报告有 FD、ORD 和 NRD。与 NRD 相比，超过 80%的 FD 患者在最近一次就诊时咨询了他们的常规初级保健医生，而 NRD 患者只有 27%。与 ORD 或 NRD 患者相比，FD 患者在就诊后更有能力，并更有可能向家人和朋友推荐他们的医生。FD 组和 ORD 组比 NRD 组更有可能报告健康状况整体改善和满意度提高。与其他两组相比，FD 组更有可能报告收到有关诊断、性质和预期病程的解释，并解决了患者的关注问题。患者赋权与解释诊断、性质和预期病程以及解决患者的关注问题有关。
结论
有固定 FD 的人更有可能在咨询中感到有能力，并体验到以患者为中心的护理。
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