Li Haitao, Wei Xiaolin, Wong Martin C S
School of Medicine, Shenzhen University, Shenzhen, China.
Division of Clinical Public Health and Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada.
BMC Fam Pract. 2017 Dec 29;18(1):114. doi: 10.1186/s12875-017-0683-4.
Monitoring and evaluating changes of quality of primary care for older adult hypertensive patients is part of effective delivery of primary care. This study aimed to investigate changes of older adult hypertensive patients' perceived quality of primary care over time in Shanghai.
Two rounds of cross-sectional questionnaire surveys were conducted in Shanghai in November 2011 and June 2013. A total of 437 patients participated in the first Round survey and 443 in the second. Primary care attributes were collected from Community Health Center users through on-site face-to-face interview surveys using the validated Primary Care Assessment Tool. Multiple linear regressions were used to determine whether there was any difference in primary quality of care scores between 2011 and 2013 surveys.
Compared with those in the first Round, participants in the second Round reported higher scores in total primary care quality (28.73 vs. 27.75, P < 0.001), as well as primary care attributes including first-contact utilization (2.81 vs. 2.60, P < 0.001) and accessibility (2.48 vs. 2.44, P < 0.05), continuity of care (3.38 vs. 3.27, P < 0.001), coordination of information (3.82 vs. 3.67, P < 0.001), comprehensiveness of service availability (3.51 vs. 3.39, P < 0.001) and provision (2.69 vs. 2.43, P < 0.001), and cultural competence (2.67 vs. 2.49, P < 0.05), but a lower score in coordination of services (2.45 vs. 2.55, P < 0.05).
Older adult hypertensive patients perceived better primary care quality from 2011 to 2013 in Shanghai. This may be associated with the general practitioner team service in Shanghai where hypertensive patients were targeted.
监测和评估老年高血压患者初级保健质量的变化是有效提供初级保健的一部分。本研究旨在调查上海老年高血压患者对初级保健的感知质量随时间的变化。
2011年11月和2013年6月在上海进行了两轮横断面问卷调查。第一轮调查共有437名患者参与，第二轮有443名。通过使用经过验证的初级保健评估工具，通过现场面对面访谈调查从社区卫生中心用户中收集初级保健属性。使用多元线性回归来确定2011年和2013年调查之间初级保健质量得分是否存在差异。
与第一轮相比，第二轮参与者在初级保健总质量（28.73对27.75，P < 0.001）以及初级保健属性方面得分更高，包括首次接触利用率（2.81对2.60，P < 0.001）和可及性（2.48对2.44，P < 0.05）、连续性护理（3.38对3.27，P < 0.001）、信息协调性（3.82对3.67，P < 0.001）、服务可及性的全面性（3.51对3.39，P < 0.001）和提供情况（2.69对2.43，P < 0.001）以及文化能力（2.67对2.49，P < 0.05），但服务协调性得分较低（2.45对2.55，P < 0.05）。
2011年至2013年期间，上海老年高血压患者对初级保健质量的感知有所改善。这可能与上海以高血压患者为目标人群的全科医生团队服务有关。
