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持续护理:未参保免费诊所患者的观点

Continuity of Care: Perspectives of Uninsured Free Clinic Patients.

作者信息

Kamimura Akiko, Panahi Samin, Ahmmad Zobayer, Stoddard Mary, Weaver Shannon, Ashby Jeanie

机构信息

Department of Sociology, University of Utah, Salt Lake City, UT, USA.

International Affairs and Global Enterprise, University of Utah, Salt Lake City, UT, USA.

出版信息

J Patient Exp. 2019 Dec;6(4):305-310. doi: 10.1177/2374373518805098. Epub 2018 Oct 9.

Abstract

BACKGROUND

Continuity of care is vital to the success of a health-care system because it improves patient satisfaction and health outcomes, and reduces hospitalizations and emergency room visits.

OBJECTIVE

The purpose of this study was to examine free clinic patients' perspectives of continuity of care in the United States.

METHOD

A convenience sample of free clinic patients who were the age of 18 or older and spoke English or Spanish participated in a self-administered survey from January to April in 2017 (N = 580).

RESULTS

Better instructions from providers were associated with higher levels of continuity of care ( < .01). Higher levels of stress and worse self-rated general health were related to lower levels of continuity of care ( < .05 for stress, < .01 for general health). Being employed was associated with lower levels of continuity of care ( < .05). Non-US born English speakers and Spanish speakers rated continuity of care higher than US born English speakers ( < .01).

CONCLUSION

Even if a patient is unable to see the same physician over time, quality instructions from a well-coordinated provider team may enhance continuity of care from patient perspectives. The social context of patients such as working poor individuals is very important for providers to understand in order to identify barriers to continuity of care.

摘要

背景

医疗服务的连续性对医疗保健系统的成功至关重要,因为它能提高患者满意度和改善健康结果,并减少住院次数和急诊室就诊次数。

目的

本研究的目的是调查美国免费诊所患者对医疗服务连续性的看法。

方法

2017年1月至4月,选取年龄在18岁及以上、讲英语或西班牙语的免费诊所患者作为便利样本,参与一项自填式调查(N = 580)。

结果

提供者给出的更好的指导与更高水平的医疗服务连续性相关(P <.01)。更高水平的压力和更差的自我评定总体健康状况与更低水平的医疗服务连续性相关(压力P <.05,总体健康状况P <.01)。就业与更低水平的医疗服务连续性相关(P <.05)。非美国出生的英语使用者和西班牙语使用者对医疗服务连续性的评分高于美国出生的英语使用者(P <.01)。

结论

即使患者无法长期看同一位医生,但来自协调良好的提供者团队的高质量指导可能会从患者角度提高医疗服务的连续性。提供者了解患者的社会背景,如贫困劳动者,对于识别医疗服务连续性的障碍非常重要。

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