Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Family Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea.
PLoS One. 2020 Mar 10;15(3):e0230034. doi: 10.1371/journal.pone.0230034. eCollection 2020.
Primary care is not well established in Korea despite its importance in population health. To reinforce the primary care system, understanding the public view of primary care will be essential. We aimed to compare the public perception of primary care qualities across types of healthcare facilities. We conducted a cross-sectional, web-based survey at a university in Seoul, South Korea, from October 2018 to February 2019. Using the Korean Primary Care Assessment Tool (K-PCAT), participants assessed the qualities of primary care services provided by the university health service (a university-based, patient-centered primary care model), community clinics, and hospitals. We compared K-PCAT scores across facilities and evaluated the factors associated with the differences using general linear models. A total of 5,748 responses were analyzed. K-PCAT total scores were highest for the university health service (61.0 ± 15.9) and lowest for hospitals (48.1 ± 14.5), with significant differences between facilities (P < .001). The university health service received the highest scores for first contact, comprehensiveness, personalized care, and family/community orientation; community clinics for continuity of care; and hospitals for care coordination and trust/satisfaction. Primary care facilities were rated higher than hospitals by individuals in good health, with low income levels, using ambulatory care more frequently, and spending less on medical expenses. In conclusion, the user-perceived primary care quality was higher for community-based primary care facilities than hospitals. The highest score was for the university health service, suggesting that setting-based, patient-centered primary care would be an effective model for restructuring the primary care system in Korea.
韩国的初级保健虽然对民众健康很重要，但并未得到很好的建立。为了加强初级保健体系，了解公众对初级保健的看法至关重要。我们旨在比较不同类型医疗保健机构中公众对初级保健质量的看法。我们于 2018 年 10 月至 2019 年 2 月在韩国首尔的一所大学进行了一项横断面、基于网络的调查。使用韩国初级保健评估工具（K-PCAT），参与者评估了大学保健服务（一种以大学为基础、以患者为中心的初级保健模式）、社区诊所和医院提供的初级保健服务的质量。我们比较了各医疗机构的 K-PCAT 评分，并使用一般线性模型评估了导致差异的因素。共分析了 5748 份回复。大学保健服务的 K-PCAT 总分最高（61.0±15.9），医院最低（48.1±14.5），各医疗机构之间存在显著差异（P<.001）。大学保健服务在首诊、全面性、个性化护理和家庭/社区导向方面得分最高；社区诊所在连续护理方面得分较高；而医院在护理协调和信任/满意度方面得分较高。健康状况良好、收入水平较低、经常使用门诊护理和医疗费用支出较少的人认为初级保健机构的初级保健质量高于医院。得分最高的是大学保健服务，这表明基于场所的、以患者为中心的初级保健将是韩国重构初级保健系统的有效模式。
