Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America.
Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, University of Heidelberg, Heidelberg, Germany.
PLoS One. 2019 Jan 30;14(1):e0210563. doi: 10.1371/journal.pone.0210563. eCollection 2019.
In this study, we aim to establish the impact of the introduction of the Family Medicine Model patient satisfaction in the Turkish health system.
We use data on data 69,028 primary health care (PHC) patients over the period 2010-2012. We estimate the impact of the Family Medicine Model in panel regressions with province fixed effects, exploiting the sequential introduction of this health systems transformation across Turkey's 81 provinces. We use principal component analysis to reduce the dimensionality of the data from the European Patients Evaluate General/Family Practice (EUROPEP) patient satisfaction survey, to focus on the fundamental dimensions of patient satisfaction and to decrease the need for multiple hypothesis testing. We identified two key principal components. The first captured primarily information on satisfaction with provider behavior and the second on satisfaction with the organization of care. We then use these two principal components as outcome variables in our panel analysis to estimate the causal impact of the introduction of the Family Medicine Model.
The Family Medicine Model significantly improved patient satisfaction across a range of dimensions. The coefficient results showed a positive and statistically significant impact (p-values<0.05) of the Family Medicine Model on the outcome variables representing the satisfaction dimensions clinical behaviour and the organization of care even after controlling for calendar time fixed effects.
The introduction of the Family Medicine Model in Turkey, which was primarily aimed at achieving universal health coverage goals, substantially improved patient satisfaction. This study provides some of the first national-level evidence that the introduction of a Family Medicine Model can substantially improve patient satisfaction.
本研究旨在探讨家庭医学模式在土耳其卫生系统中引入对患者满意度的影响。
我们使用了 2010-2012 年期间 69028 名初级卫生保健（PHC）患者的数据。我们利用该卫生系统转型在土耳其 81 个省份的顺序引入，通过面板回归中的省份固定效应来估计家庭医学模式的影响。我们使用主成分分析来降低 EUROPEP 患者满意度调查数据的维度，以关注患者满意度的基本维度并减少对多个假设检验的需求。我们确定了两个关键的主成分。第一个主要捕捉了对提供者行为满意度的信息，第二个主要捕捉了对护理组织满意度的信息。然后，我们将这两个主成分作为面板分析中的因变量，以估计家庭医学模式引入的因果影响。
家庭医学模式在一系列维度上显著提高了患者满意度。即使在控制了日历时间固定效应后，系数结果也显示家庭医学模式对代表临床行为和护理组织满意度的两个因变量具有积极且具有统计学意义的影响（p 值<0.05）。
土耳其引入家庭医学模式主要是为了实现全民健康覆盖目标，这大大提高了患者的满意度。本研究提供了一些首个国家级证据，表明引入家庭医学模式可以显著提高患者满意度。
