Wang Wenhua, Shi Leiyu, Yin Aitian, Mao Zongfu, Maitland Elizabeth, Nicholas Stephen, Liu Xiaoyun
School of Public Health, Wuhan University, 115 Donghu Road, Wuhan, Hubei Province, 430071, People's Republic of China.
Center for Health Management and Policy, Shandong University, 44 Wenhuaxilu, Jinan, Shandong Province, 250012, People's Republic of China.
Int J Equity Health. 2015 May 14;14:45. doi: 10.1186/s12939-015-0174-y.
This paper assesses both patients' perspectives on the differences in primary care quality between traditional Tibetan medicine (TTM) hospitals and western medicine (WM) hospitals and the efficacy of the government's investment in these two Prefecture-level primary care structures in Tibet.
A validated Tibetan version of the Primary Care Assessment Tool (PCAT-T) was used to collect data on 692 patients aged over 18 years old, who reported the sampling site was their regular source of health care. T-tests were performed to compare the separate and total primary care attributes between WM hospitals and TTM hospitals. Multiple linear regression analysis was conducted to examine the association of the health care setting with primary care attributes while controlling for socio-demographic, health service use and health status characteristics.
Compared to WM hospitals, the results showed that TTM hospitals had patients who were older (15.8 % versus 8.4 % over 60 years); with lower education levels (66.0 % versus 35.8 % with below junior high school ) and income levels (46.9 % versus 26.5 % with annual household income below 30,000RMB); more likely to be married (79.2 % versus 60.5 %); made less frequent health care visits; and had higher self-rated health status. Overall, patients assessed the primary care performance in TTM hospitals significantly higher (80.0) than WM hospitals (74.63). There were no differences in health care assessment by patient gender, age, income, education, marital status and occupation.
TTM patients reported better primary care experiences than patients using WM hospitals, which validated the government's investment in traditional Tibetan medicine.
本文评估了患者对藏医医院和西医医院初级保健质量差异的看法,以及政府对西藏这两个地区级初级保健机构投资的成效。
使用经过验证的藏文版初级保健评估工具(PCAT-T)收集了692名18岁以上患者的数据,这些患者报告抽样地点是他们常规的医疗保健来源。进行t检验以比较西医医院和藏医医院之间单独和总体的初级保健属性。进行多元线性回归分析,以检验医疗保健机构与初级保健属性之间的关联,同时控制社会人口统计学、卫生服务使用和健康状况特征。
与西医医院相比,结果显示藏医医院的患者年龄更大(60岁以上患者占15.8%,而西医医院为8.4%);教育水平较低(初中以下学历占66.0%,而西医医院为35.8%),收入水平较低(家庭年收入低于30,000元人民币的占46.9%,而西医医院为26.5%);结婚的可能性更高(79.2%,而西医医院为60.5%);医疗保健就诊频率较低;自我评估的健康状况较高。总体而言,患者对藏医医院初级保健表现的评估(80.0)显著高于西医医院(74.63)。患者的性别年龄、收入、教育、婚姻状况和职业对医疗保健评估没有差异。
藏医患者报告的初级保健体验优于使用西医医院的患者,这证实了政府对传统藏医的投资。