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公共和私人初级保健提供者之间未满足的医疗保健需求的差异:基于人群的研究。

Differences in unmet healthcare needs between public and private primary care providers: A population-based study.

机构信息

1 Social Medicine and Health Policy in Malmö, Department of Clinical Sciences, Lund University, Lund, Sweden.

2 Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.

出版信息

Scand J Public Health. 2018 Jun;46(4):488-494. doi: 10.1177/1403494818762983. Epub 2018 Mar 19.

Abstract

AIMS

To investigate if any differences in unmet healthcare needs between persons registered at public and private primary care providers exist in Skåne (southernmost Sweden).

METHODS

The 2012 public health survey in Skåne was conducted with a postal questionnaire and included 28,029 respondents aged between 18 and 80 years. The study was cross-sectional. If the responder in the last three months had perceived oneself to be in need of medical care by a physician but did not seek it, this was used as a measure of unmet healthcare needs. Differences in unmet healthcare needs in relation to the primary care provider were investigated while adjusting for socioeconomic status and self-rated health in a logistic regression.

RESULTS

Differences in unmet healthcare needs were small and non-significant when comparing public and private healthcare providers. Non-manual workers were to a somewhat higher extent using private providers while manual workers showed a reverse pattern. Unmet healthcare needs had decreased slightly since 2008, but so had the response rate.

CONCLUSIONS

With the current primary care system, no significant differences in unmet healthcare needs seem to exist when comparing public and private providers. It is likely that the providers are similar in their organizational setup, accessibility and doctor-patient continuity. Still more studies need to be done, preferably in a way so that uncertainty about what type of primary care provider the respondent is listed at can be avoided and perhaps using a longer time interval for unmet needs so that more subjects could be included.

摘要

目的

调查在瑞典斯科讷(最南部),在公共和私人初级保健提供者登记的人群之间是否存在未满足的医疗保健需求方面的差异。

方法

2012 年在斯科讷进行了一项基于邮寄问卷的公共卫生调查,共纳入了 28029 名年龄在 18 至 80 岁之间的应答者。该研究为横断面研究。如果应答者在过去三个月中认为自己需要医生的医疗护理但未寻求,则将此作为未满足的医疗保健需求的衡量标准。在调整了社会经济地位和自我评估健康状况后,通过逻辑回归调查了与初级保健提供者相关的未满足的医疗保健需求的差异。

结果

与公共和私人医疗保健提供者相比,未满足的医疗保健需求的差异较小且无统计学意义。非体力劳动者更多地使用私人提供者,而体力劳动者则呈现相反的模式。自 2008 年以来,未满足的医疗保健需求略有下降,但响应率也有所下降。

结论

在当前的初级保健系统中,比较公共和私人提供者,似乎不存在未满足的医疗保健需求的显著差异。提供者在组织设置、可及性和医患连续性方面可能相似。仍需要进行更多的研究,最好是在可以避免应答者所登记的初级保健提供者类型不确定的情况下进行,并且可能使用更长的时间间隔来衡量未满足的需求,以便纳入更多的研究对象。

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