是否有固定初级保健医生的患者在心理困扰方面得到的照顾不同？

Do patients with and without a regular primary care physician have their psychological distress looked after differently?

机构信息

Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China.

Department of Statistics and Actuarial Science, The University of Hong Kong, Hong Kong, China.

出版信息

J Public Health (Oxf). 2019 Jun 1;41(2):399-404. doi: 10.1093/pubmed/fdy112.

DOI:10.1093/pubmed/fdy112

PMID:29982744

Abstract

BACKGROUND

While qualitative studies suggested that continuity of care by primary care physicians (PCPs) facilitated consultations for psychological problems, there was limited quantitative evidence. This survey compared management of psychological distress between patients with and without a regular PCP.

METHODS

A questionnaire survey was conducted with 1626 adult primary care attenders from 13 private and 6 public clinics in Hong Kong. Management of psychological distress between respondents with a regular PCP and those without were compared. Effects of demographic factors were adjusted for by multivariable logistic regression.

RESULTS

Among the 1626 respondents, 650 (40.0%) reported that they had ever experienced psychological distress. Of the 650 respondents experienced distress, 307 (47.2%) had a regular PCP. A significantly higher proportion of patients with a regular PCP than those without reported: (i) their PCPs sometimes/often asked about psychological problems [37.7 versus 20.1%, adjusted OR = 2.241]; (ii) they sometimes/often mentioned their psychological problems to PCPs [45.2 versus 24.9%, adjusted OR = 2.503]; and (iii) their distress had been treated by PCPs [22.1 versus 13.4%, adjusted OR = 1.702].

CONCLUSION

Patients with a regular PCP have around double odds of receiving mental health care. Continuity of care by PCPs should be emphasized in mental health care delivery.

摘要

背景

虽然定性研究表明，初级保健医生（PCP）提供的连续性护理有助于解决心理问题，但定量证据有限。本调查比较了有规律的 PCP 和无规律的 PCP 的患者的心理困扰管理情况。

方法

对香港 13 家私人诊所和 6 家公立医院的 1626 名成年初级保健就诊者进行了问卷调查。比较了有规律的 PCP 和无规律的 PCP 的受访者之间的心理困扰管理情况。采用多变量逻辑回归调整了人口统计学因素的影响。

结果

在 1626 名受访者中，有 650 名（40.0%）报告曾经历过心理困扰。在 650 名有心理困扰的受访者中，有 307 名（47.2%）有固定的 PCP。有固定 PCP 的患者比没有固定 PCP 的患者更有可能报告：（i）他们的 PCP 有时/经常询问心理问题[37.7%比 20.1%，调整后的 OR=2.241]；（ii）他们有时/经常向 PCP 提及自己的心理问题[45.2%比 24.9%，调整后的 OR=2.503]；以及（iii）他们的困扰已由 PCP 治疗[22.1%比 13.4%，调整后的 OR=1.702]。