Liu Xiaojun, Tan Anran, Towne Samuel D, Hou Zhaoxun, Mao Zongfu
School of Health Science, Wuhan University, Wuhan, China.
Global Health Institute, Wuhan University, Wuhan, China.
BMJ Open. 2018 Mar 16;8(3):e020605. doi: 10.1136/bmjopen-2017-020605.
General practitioners (GPs) are highly underutilised in China with many patients going directly to hospitals when seeking routine care. Multiple countries around the world have successfully used GPs in routine care, and as such, China may benefit from the use of GPs. This study examines the status of, and factors associated with, knowledge related to GPs among outpatient populations from China's tertiary hospitals.
This is a cross-sectional survey study.
The questionnaires were completed by 565 outpatients from four tertiary hospitals in China during 2016. Convenience sampling on different floors and throughout the outpatient building was carried out.
We used the logistic regression models to identify GP-related knowledge among different populations.
Overall, 50.27% of respondents said they had never heard of GPs. This was also true among females (adjusted OR (AOR)=1.57, 95% CI 1.43 to 2.71), older adults (AOR=1.61, 95% CI 1.39 to 2.98; AOR=2.01, 95% CI 1.62 to 3.59), those with lower education level (AOR=0.61, 95% CI 0.20 to 0.81; AOR=0.49, 95% CI 0.23 to 0.76), rural residents (AOR=1.51, 95% CI 1.35 to 2.82) and those with chronic disease (AOR=0.61, 95% CI 0.22 to 0.71). What is more, less than one-in-ten (9.03%) outpatients were able to accurately describe what a GP was, with less than 30% accurately describing a GP among those receiving GPs' services.
Outpatients who could have received less costly health services from GPs in primary medical institutions were more likely to choose costlier specialist physicians in tertiary hospitals, which is likely linked to limited knowledge about GPs. Policy makers should invest in outreach efforts to improve public awareness of GPs, while at the same time conducting continued surveillance of these efforts to evaluate progress towards this goal.
在中国，全科医生（GPs）的利用率极低，许多患者在寻求常规医疗服务时直接前往医院。世界上多个国家已成功将全科医生用于常规医疗服务，因此，中国或许能从全科医生的使用中受益。本研究调查了中国三级医院门诊患者中与全科医生相关的知识状况及相关影响因素。
这是一项横断面调查研究。
2016年期间，来自中国四家三级医院的565名门诊患者完成了问卷调查。在不同楼层和整个门诊大楼进行了便利抽样。
我们使用逻辑回归模型来确定不同人群中与全科医生相关的知识。
总体而言，50.27%的受访者表示他们从未听说过全科医生。女性（调整后比值比（AOR）=1.57，95%置信区间1.43至2.71）、老年人（AOR=1.61，95%置信区间1.39至2.98；AOR=2.01，95%置信区间1.62至3.59）、教育水平较低者（AOR=0.61，95%置信区间0.20至0.81；AOR=0.49，95%置信区间0.23至0.76）、农村居民（AOR=1.51，95%置信区间1.35至2.82）以及患有慢性病者（AOR=0.61，95%置信区间0.22至0.71）中也是如此。此外，不到十分之一（9.03%）的门诊患者能够准确描述全科医生是什么，在接受全科医生服务的患者中，准确描述全科医生的不到30%。
那些本可以在基层医疗机构从全科医生处获得成本较低的医疗服务的门诊患者，更有可能选择在三级医院找成本更高的专科医生，这可能与对全科医生的了解有限有关。政策制定者应投入宣传工作，以提高公众对全科医生的认识，同时持续监测这些工作，以评估在实现这一目标方面取得的进展。
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