Tangermann Ulla, Kleij Kim-Sarah, Krauth Christian, Amelung Volker Eric
Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Medizinische Hochschule Hannover, Hannover.
Gesundheitswesen. 2019 Jun;81(6):498-504. doi: 10.1055/s-0043-119084. Epub 2018 Jan 5.
One of the central challenges in health policy is to ensure nationwide provision of primary healthcare services. However, it is not clear how the general public rates the current primary healthcare provision in their region. Furthermore, there is very little information on whether people are willing to make use of new models of care that could contribute to ensuring a nationwide provision of healthcare services. Thus, the objective of this study was to analyse the general public's ratings of the local primary healthcare provision as well as their acceptance of selected new models of care. Furthermore, potential differences in the ratings of the population between hard to serve regions and normal regions will be analysed.
Focus group discussions and a literature review were conducted in order to develop a questionnaire to elicit the expectations of the population concerning the local provision of primary healthcare as well as their acceptance of new models of care. A postal questionnaire was sent to a random sample of 2,000 persons in 8 regions in Lower Saxony.
The adjusted response rate of the postal survey was 51% (n=996). 97% of respondents saw a general practitioner regularly, with 5.4 visits per year on average. Patients could reach the practice in 13 min on average. Respondents predominantly rated the current healthcare provision as being good. However, the majority of respondents expected the local primary healthcare provision to deteriorate in the future. New models of care most preferred by the respondents were the delegation of medical tasks to non-medical professionals and mobility-oriented models. On the other hand, the provision of healthcare via telemedicine was rejected.
According to the results of this study, respondents believe that new models of care can play an important role in ensuring the nationwide provision of healthcare services. Introducing, at an early stage, those new models of care that people accept could contribute to ensuring a sustainable provision of primary healthcare services. Furthermore, the introduction of these new models of care could reduce the public's concerns regarding a worsening provision of primary healthcare services in their regions. Additionally, pilot projects with those new models of care that are rather rejected might increase acceptance with these models of care if they prove to be successful.
卫生政策的核心挑战之一是确保在全国范围内提供初级医疗服务。然而，目前尚不清楚公众如何评价其所在地区当前的初级医疗服务。此外，关于人们是否愿意采用有助于确保全国范围内提供医疗服务的新型护理模式的信息非常少。因此，本研究的目的是分析公众对当地初级医疗服务的评价以及他们对选定新型护理模式的接受程度。此外，还将分析难以服务地区和正常地区人群评价的潜在差异。
进行焦点小组讨论和文献综述，以制定一份问卷，了解公众对当地初级医疗服务的期望以及他们对新型护理模式的接受程度。向德国下萨克森州8个地区的2000人随机样本发送了邮政问卷。
邮政调查的调整后回复率为51%（n = 996）。97%的受访者定期看全科医生，平均每年就诊5.4次。患者平均13分钟就能到达诊所。受访者大多认为当前的医疗服务良好。然而，大多数受访者预计当地的初级医疗服务未来会恶化。受访者最喜欢的新型护理模式是将医疗任务委托给非医疗专业人员以及以移动性为导向的模式。另一方面，通过远程医疗提供医疗服务遭到了拒绝。
根据本研究的结果，受访者认为新型护理模式在确保全国范围内提供医疗服务方面可以发挥重要作用。尽早引入人们接受的新型护理模式有助于确保初级医疗服务的可持续提供。此外，引入这些新型护理模式可以减少公众对其所在地区初级医疗服务恶化的担忧。此外，如果那些遭到相当程度拒绝的新型护理模式的试点项目证明是成功的，可能会增加人们对这些模式的接受度。
