健康素养、医疗可及性及医疗协调对德国患者初级医疗满意度的影响。
Impact of health literacy, accessibility and coordination of care on patient's satisfaction with primary care in Germany.
作者信息
Altin Sibel Vildan, Stock Stephanie
机构信息
Institute for Health Economics and Clinical Epidemiology, University Hospital of Cologne, Gleuelerstr. 176-178, 50935, Cologne, Germany.
出版信息
BMC Fam Pract. 2015 Oct 22;16:148. doi: 10.1186/s12875-015-0372-0.
BACKGROUND
Although health policy makers call for the transformation of health care organizations to health literacy responsive ones, there is limited evidence on the care experiences of patients with limited health literacy skills (HL) in respect to health care quality. We explored if HL and patient-reported experiences regarding access to care and support in care-coordination in primary care organizations (PCO) have an impact on patients satisfaction with the care received by their personal general practitioner (GP).
METHODS
A nationwide representative survey was administered in a random sample of 1125 German adults. Binary logistic regression analyses were performed to determine whether HL and perceived access to and coordination of care were associated with satisfaction with care received in primary care adjusting for demographics and health status.
RESULTS
In the unadjusted as well as adjusted model, better accessibility of the primary care practice (β= 1.858; 2.032 p < 0.001) frequent support in care coordination by the general practitioner (β = 2.680; 2.820 p < 0.001) as well as sufficient HL (β = 0.888; 1.228 p < 0.05) were independent predictors of a higher satisfaction with care received in the general practice.
CONCLUSION
German adults with sufficient HL and positive experiences regarding care coordination and access to care are more satisfied with care received by their personal general practitioner. This result is from major importance for primary care organizations intending to transform their processes and structures to respond to the health literacy needs of their patients more effectively.
背景
尽管卫生政策制定者呼吁医疗保健组织转变为具备健康素养响应能力的组织，但关于健康素养技能有限（HL）的患者在医疗质量方面的护理体验的证据有限。我们探讨了HL以及患者报告的在初级保健组织（PCO）中获得护理协调方面的护理和支持的经历是否会影响患者对其个人全科医生（GP）所提供护理的满意度。
方法
对1125名德国成年人的随机样本进行了一项全国代表性调查。进行二元逻辑回归分析，以确定HL以及感知到的获得护理和护理协调情况是否与在调整人口统计学和健康状况后对初级保健中所接受护理的满意度相关。
结果
在未调整和调整后的模型中，初级保健机构更好的可及性（β = 1.858；2.032，p < 0.001）、全科医生在护理协调方面的频繁支持（β = 2.680；2.820，p < 0.001）以及足够的HL（β = 0.888；1.228，p < 0.05）是对全科医疗中所接受护理更高满意度的独立预测因素。
结论
具备足够HL以及在护理协调和获得护理方面有积极体验的德国成年人对其个人全科医生所提供的护理更满意。这一结果对于打算转变其流程和结构以更有效地响应患者健康素养需求的初级保健组织至关重要。
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