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患者报告的全科医疗质量改进领域:一项横断面调查。

Patient-reported areas for quality improvement in general practice: a cross-sectional survey.

作者信息

Waller Amy, Carey Mariko, Mazza Danielle, Yoong Serene, Grady Alice, Sanson-Fisher Rob

机构信息

Health Behaviour Research Group, Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia.

Department of General Practice, School of Primary Health Care, Monash University, Victoria, Australia.

出版信息

Br J Gen Pract. 2015 May;65(634):e312-8. doi: 10.3399/bjgp15X684841.

Abstract

BACKGROUND

GPs are often a patient's first point of contact with the health system. The increasing demands imposed on GPs may have an impact on the quality of care delivered. Patients are well placed to make judgements about aspects of care that need to be improved.

AIM

To determine whether general practice patients perceive that the care they receive is 'patient-centred' across eight domains of care, and to determine the association between sociodemographic, GP and practice characteristics, detection of preventive health risks, and receipt of patient-centred care.

DESIGN AND SETTING

Cross-sectional survey of patients attending Australian general practice clinics.

METHOD

Patients completed a touchscreen survey in the waiting room to rate the care received from their GP across eight domains of patient-centred care. Patients also completed the Patient Health Questionnaire (PHQ-9) and self-reported health risk factors. GPs completed a checklist for each patient asking about the presence of health risk factors.

RESULTS

In total 1486 patients and 51 GPs participated. Overall, 83% of patients perceived that the care they received was patient-centred across all eight domains. Patients most frequently perceived the 'access to health care when needed' domain as requiring improvement (8.3%). Not having private health insurance and attending a practice located in a disadvantaged area were significantly associated with perceived need for improvements in care (P<0.05).

CONCLUSION

Patients in general practice report that accessibility is an aspect of care that could be improved. Further investigation of how indicators of lower socioeconomic status interact with the provision of patient-centred care and health outcomes is required.

摘要

背景

全科医生通常是患者与医疗系统的首个接触点。加诸于全科医生的需求不断增加,可能会对所提供的医疗服务质量产生影响。患者能够很好地判断需要改进的医疗服务方面。

目的

确定全科医疗患者是否认为他们所接受的医疗服务在八个医疗领域是“以患者为中心”的,并确定社会人口统计学、全科医生和诊所特征、预防性健康风险的检测与以患者为中心的医疗服务的接受之间的关联。

设计与设置

对澳大利亚全科医疗诊所的患者进行横断面调查。

方法

患者在候诊室完成触摸屏调查,以对他们从全科医生那里获得的八个以患者为中心的医疗领域的服务进行评分。患者还完成了患者健康问卷(PHQ-9)并自我报告了健康风险因素。全科医生为每位患者填写一份关于健康风险因素存在情况的清单。

结果

共有1486名患者和51名全科医生参与。总体而言,83%的患者认为他们所接受的医疗服务在所有八个领域都是以患者为中心的。患者最常认为“需要时获得医疗服务”这一领域需要改进(8.3%)。没有私人医疗保险以及在弱势地区的诊所就诊与认为需要改进医疗服务显著相关(P<0.05)。

结论

全科医疗中的患者报告称可及性是医疗服务中可以改进的一个方面。需要进一步研究社会经济地位较低的指标如何与以患者为中心的医疗服务提供和健康结果相互作用。

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