Department of ambulatory care and community medicine, Institute of Family Medicine, University of Lausanne, Lausanne, Switzerland.
BMC Fam Pract. 2019 Jan 25;20(1):19. doi: 10.1186/s12875-018-0895-2.
Representing 60% of medical consultations in Switzerland, primary care holds an important place in our medical system. Patients' values in family medicine (FM) are nowadays recognized as important factors to take into account in order to provide good quality of care. The aim of this study is to describe patients' most important values regarding FM and to assess their associations with socio-demographics factors in a fee-for-services health system.
We analyzed the Swiss 2012 study on Quality and Costs of Primary Care (QUALICOPC). Two-hundred patients, randomly drawn, answered a questionnaire about their values regarding FM just after their consultation. Explored values were related to communication and patient-centeredness care, continuity and coordination, care access, and patients' activation. We described values reaching more than 50% of "very important". Then, multivariate analyses were performed for the most important value of each dimension.
Items related to "communication and patient-centeredness care" and "coordination and continuity of care" are the most recurrently mentioned as "very important". Items related to access and patients' activation are generally declared as "very important" by less than 50% of patients. Whatever the domain and the item, women systematically grant items more often as "very important" than men. Variations are observed according to the age, and the presence or not of a chronic disease.
Such dimensions should be subject to a special attention by general practitioners and public health authorities as it might enhance the quality of care and the patients' satisfaction.
在瑞士,初级保健占医疗咨询的 60%,在我们的医疗体系中占有重要地位。如今,患者在家庭医学中的价值观被认为是提供高质量医疗服务的重要因素。本研究旨在描述患者对家庭医学最重要的价值观,并评估这些价值观与按服务收费医疗体系中社会人口因素的相关性。
我们分析了 2012 年瑞士关于初级保健质量和成本的研究(QUALICOPC)。随机抽取 200 名患者,在就诊后立即回答一份关于家庭医学价值观的问卷。所探讨的价值观与沟通和以患者为中心的护理、连续性和协调性、护理可及性以及患者的积极性有关。我们描述了达到“非常重要”比例超过 50%的价值观。然后,对每个维度的最重要价值观进行了多变量分析。
与“沟通和以患者为中心的护理”和“协调和连续护理”相关的项目是最常被提及的“非常重要”项目。与获取和患者积极性相关的项目通常只有不到 50%的患者认为“非常重要”。无论在哪个领域和项目,女性系统地将更多的项目评定为“非常重要”,而男性则不然。根据年龄和是否存在慢性病,存在差异。
这些方面应该引起全科医生和公共卫生当局的特别关注,因为这可能会提高医疗服务质量和患者满意度。