Kim Yeon-Yong, Bae Jaekyoung, Lee Jin-Seok
Big Data Steering Department, National Health Insurance Service, Wonju.
Department of Health Policy and Management, Seoul National University College of Medicine.
Patient Prefer Adherence. 2017 Nov 22;11:1933-1938. doi: 10.2147/PPA.S148530. eCollection 2017.
Primary care is relatively weak in the Republic of Korea. As the referral system is not well established, patients can freely choose from among clinics, hospitals, and tertiary hospitals. This study was conducted to determine the factors influencing patients' choice of providers.
A survey was conducted of 999 Korean adults aged 19-59 years. An exploratory factor analysis was performed on nine factors influencing their motives in choosing a medical provider. The factors derived from this analysis and the types of medical institutions were used as the independent and dependent variables, respectively, in logistic regression analysis. Adjustments were made for region, gender, age, educational level, income, type of insurance, and chronic diseases.
The results showed that patients preferred clinics when considering the importance of accessibility, staff kindness, and patient-centeredness; they preferred hospitals when considering cleanliness; and tertiary hospitals when considering the reputation and structural factors. When considering structural factors, clinics and hospitals were less preferred; however tertiary hospitals were less preferred when considering accessibility, staff kindness, and patient-centeredness.
It is necessary to provide more accessible and patient-centered services in order to strengthen the primary health care role of clinics. In addition, efforts are needed to improve the quality of health care of tertiary hospitals in order to meet patient expectations.
韩国的初级医疗保健相对薄弱。由于转诊系统不完善，患者可以在诊所、医院和三级医院中自由选择。本研究旨在确定影响患者选择医疗服务提供者的因素。
对999名年龄在19 - 59岁的韩国成年人进行了调查。对影响他们选择医疗服务提供者动机的九个因素进行了探索性因素分析。该分析得出的因素和医疗机构类型分别用作逻辑回归分析中的自变量和因变量。对地区、性别、年龄、教育程度、收入、保险类型和慢性病进行了调整。
结果表明，在考虑可及性、工作人员友善度和以患者为中心的重要性时，患者更喜欢诊所；在考虑清洁程度时，更喜欢医院；在考虑声誉和结构因素时，更喜欢三级医院。在考虑结构因素时，诊所和医院较不受青睐；然而，在考虑可及性、工作人员友善度和以患者为中心时，三级医院较不受青睐。
有必要提供更易获得且以患者为中心的服务，以加强诊所的初级卫生保健作用。此外，需要努力提高三级医院的医疗质量，以满足患者的期望。
