Li Haitao, Wei Xiaolin, Wong Martin Chi-Sang, Wong Samuel Yeung-Shan, Yang Nan, Griffiths Sian M
From the School of Medicine, Shenzhen University, Shenzhen, China (HL) and School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China (XW, MC-SW, SY-SW, NY, SMG).
Medicine (Baltimore). 2015 Aug;94(34):e1388. doi: 10.1097/MD.0000000000001388.
Hypertension should be best managed under primary care settings. This study aimed to compare, between Shanghai and Shenzhen, the perceived quality of primary care in terms of accessibility, continuity, co-ordination, and comprehensiveness among hypertensive patients.A cross-sectional study was conducted in Shanghai and Shenzhen, China. Multistage random sampling method was used to select 8 community health centers. Data from primary care users were collected through on-site face-to-face interviews using the primary care assessment tool. Good quality standard was set as a value of 3 for each attribute and a value of 18 for total score.We included 568 patients in Shanghai and 128 patients in Shenzhen. Compared with those in Shenzhen, hypertensive patients in Shanghai reported a higher score in co-ordination of information (3.37 vs 3.66; P < 0.001), but lower scores in continuity of care (3.36 vs 3.27; P < 0.001), and comprehensiveness-service provision (3.26 vs 2.79; P < 0.001). There was no statistically significant difference in total scores between the 2 cities (18.19 vs 18.15). Over 3-quarters of hypertensive patients in both cities reported accessibility (97.2% vs 91.4%) and co-ordination of services (76.1% vs 80.5%) under good quality standard, while <1-quarter of them rated continuity of care (23.6% vs 22.7%), co-ordination of information (4.8% vs 21.1%), and comprehensiveness-service availability (15.1% vs 25.0%) under that standard.Compared with Shenzhen, the perceived quality of primary care for hypertensive patients in Shanghai was better in terms of co-ordination of information, but poorer on continuity of care and comprehensiveness-service provision. Our study suggests that there is room for quality improvement in both cities.
高血压最好在初级保健机构中进行管理。本研究旨在比较上海和深圳两地高血压患者对初级保健在可及性、连续性、协调性和全面性方面的感知质量。在中国上海和深圳进行了一项横断面研究。采用多阶段随机抽样方法选取了8个社区卫生中心。通过使用初级保健评估工具进行现场面对面访谈，收集初级保健使用者的数据。将每个属性的良好质量标准设定为3分，总分设定为18分。我们纳入了上海的568名患者和深圳的128名患者。与深圳的患者相比，上海的高血压患者在信息协调性方面得分更高（3.37对3.66；P<0.001），但在医疗连续性方面得分更低（3.36对3.27；P<0.001），在全面性服务提供方面得分也更低（3.26对2.79；P<0.001）。两个城市的总分没有统计学上的显著差异（18.19对18.15）。两个城市超过四分之三的高血压患者报告称在良好质量标准下可及性（97.2%对91.4%）和服务协调性（76.1%对80.5%）良好，而在该标准下，只有不到四分之一的患者对医疗连续性（23.6%对22.7%）、信息协调性（4.8%对21.1%）和全面性服务可及性（15.1%对25.0%）给予好评。与深圳相比，上海高血压患者对初级保健的感知质量在信息协调性方面更好，但在医疗连续性和全面性服务提供方面较差。我们的研究表明，两个城市在质量改进方面都有空间。
