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尼日利亚私立医院预防保健的采用情况:横断面调查(Nisa premier 医院)。

Preventive healthcare uptake in private hospitals in Nigeria: a cross-sectional survey (Nisa premier hospital).

机构信息

Department of Family and Specialty Medicine, Nisa Premier Hospital, Abuja, Nigeria.

Research and Development, Nisa Premier Hospital, Abuja, Nigeria.

出版信息

BMC Health Serv Res. 2020 Apr 1;20(1):273. doi: 10.1186/s12913-020-05117-5.

Abstract

BACKGROUND

Understanding the features of preventive care uptake is critical for assessing the performance and viability of primary care in any healthcare system. There are gaps in previous studies that focused on primary healthcare features, challenges and way forward in Nigeria but were mainly public sector focused and do not characterize the features of preventive care. Since private healthcare sector remains the most accessed and utilized in Nigeria, this study sought to characterize the features of uptake of preventive care to better understand the current preventive healthcare landscape.

METHOD

A descriptive cross-sectional study, using survey questionnaire were randomly administered to adult patients attending the Family Medicine Out-Patient Department (OPD) at Nisa Premier Hospital, Jabi Abuja. The study was conducted over a three-month period. (January to June 2017). Data collected were analyzed using SPSS version 23 (IBM SPSS, Chicago, IL, USA). Descriptive statistics in the form of frequency and percentage were used to report the results.

RESULTS

A total of 381 participants completed the survey. The results revealed that while an over overwhelming majority (> 90%) of participants indicated knowledge of benefits of preventive care, and preferred interventions aimed at preventing a disease before they occur, 48% preferred interventions aimed at reducing disease or injury impact or interventions aimed at ameliorating the impact of ongoing disease or injury with long lasting effect (43%). Unfortunately, less than 40% of respondents would visit the hospital when their health condition is not serious. Important barriers to uptake of preventive care were revealed as cost (45%), distance to the healthcare provider (36%) and lack of health insurance (33%), whereas poor education (19%), social norms (13%) as well as cultural and religious beliefs (10%) towards accessing certain health services appeared to be lesser barriers.

CONCLUSION

Although people are aware of the benefits of preventive care, its uptake will greatly be enhanced through improved health insurance coverage, refocusing primary healthcare functions on preventive rather than curative care and instituting policies that mandatorily prescribe uptake for the insured, both at the individual and the insurer's level.

摘要

背景

了解预防保健服务的采用情况对于评估任何医疗保健系统中初级保健的绩效和可行性至关重要。之前的研究主要集中在尼日利亚的初级医疗保健特点、挑战和前进方向上,但存在空白,主要关注公共部门,而没有描述预防保健的特点。由于私营医疗保健部门在尼日利亚仍然是最受欢迎和使用最多的,因此本研究旨在描述预防保健服务的采用特点,以更好地了解当前的预防医疗保健状况。

方法

采用描述性横断面研究,使用问卷调查表随机对在阿布贾贾比的 Nisa Premier 医院家庭医学门诊部门就诊的成年患者进行调查。研究在三个月的时间内进行(2017 年 1 月至 6 月)。使用 SPSS 版本 23(IBM SPSS,芝加哥,IL,美国)分析收集的数据。采用频率和百分比的描述性统计来报告结果。

结果

共有 381 名参与者完成了调查。结果表明,尽管绝大多数参与者(>90%)表示了解预防保健的益处,并倾向于选择旨在预防疾病发生的干预措施,但 48%的参与者更倾向于选择旨在减轻疾病或伤害影响的干预措施,或选择具有持久影响的干预措施,以改善正在进行的疾病或伤害的影响(43%)。不幸的是,只有不到 40%的受访者在健康状况不严重时会去医院就诊。研究揭示了预防保健服务采用的重要障碍,包括费用(45%)、距离医疗服务提供者的距离(36%)和缺乏健康保险(33%),而教育程度低(19%)、社会规范(13%)以及对获取某些卫生服务的文化和宗教信仰(10%)则是较小的障碍。

结论

尽管人们意识到预防保健的好处,但通过改善健康保险覆盖范围、将初级保健服务的重点重新放在预防保健而不是治疗保健上,以及制定强制性规定保险覆盖者进行预防保健的政策,都可以大大提高预防保健的采用率,包括在个人和保险公司层面。

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