Pavlič Danica R, Sever Maja, Klemenc-Ketiš Zalika, Švab Igor, Vainieri Milena, Seghieri Chiara, Maksuti Alem
1Department of Family Medicine, Medical Faculty,University of Ljubljana,Ljubljana,Slovenia.
2Statistical Office of the Republic of Slovenia,Ljubljana,Slovenia.
Prim Health Care Res Dev. 2018 May;19(3):277-287. doi: 10.1017/S1463423617000792. Epub 2018 Jan 8.
AimWe sought to examine strength of primary care service delivery as measured by selected process indicators by general practitioners from 31 European countries plus Australia, Canada, and New Zealand. We explored the relation between strength of service delivery and healthcare expenditures.
The strength of a country's primary care is determined by the degree of development of a combination of core primary care dimensions in the context of its healthcare system. This study analyses the strength of service delivery in primary care as measured through process indicators in 31 European countries plus Australia, New Zealand, and Canada.
A comparative cross-sectional study design was applied using the QUALICOPC GP database. Data on the strength of primary healthcare were collected using a standardized GP questionnaire, which included 60 questions divided into 10 dimensions related to process, structure, and outcomes. A total of 6734 general practitioners participated. Data on healthcare expenditure were obtained from World Bank statistics. We conducted a correlation analysis to analyse the relationship between strength and healthcare expenditures.FindingsOur findings show that the strength of service delivery parameters is less than optimal in some countries, and there are substantial variations among countries. Continuity and comprehensiveness of care are significantly positively related to national healthcare expenditures; however, coordination of care is not.
目的
我们试图通过31个欧洲国家以及澳大利亚、加拿大和新西兰的全科医生所选择的过程指标来考察初级保健服务提供的力度。我们探讨了服务提供力度与医疗保健支出之间的关系。
一个国家初级保健的力度取决于其医疗保健系统背景下核心初级保健维度组合的发展程度。本研究分析了31个欧洲国家以及澳大利亚、新西兰和加拿大通过过程指标衡量的初级保健服务提供力度。
采用比较横断面研究设计,使用QUALICOPC全科医生数据库。使用标准化的全科医生问卷收集初级医疗保健力度的数据,该问卷包括60个问题,分为与过程、结构和结果相关的10个维度。共有6734名全科医生参与。医疗保健支出数据来自世界银行统计数据。我们进行了相关性分析以分析力度与医疗保健支出之间的关系。
我们的研究结果表明,在一些国家,服务提供参数的力度未达到最佳状态,而且各国之间存在很大差异。护理的连续性和全面性与国家医疗保健支出显著正相关;然而,护理协调并非如此。