有规律的全科医生（GP）和医疗保健障碍体验之间的关系：澳大利亚新南威尔士州年轻人的横断面研究，对边缘化群体进行了过采样。
The relationship between having a regular general practitioner (GP) and the experience of healthcare barriers: a cross-sectional study among young people in NSW, Australia, with oversampling from marginalised groups.
机构信息
Australian Centre for Public and Population Health Research, University of Technology Sydney, Ultimo, Australia.
Department of General Practice, The University of Sydney, Westmead Clinical School, Sydney, Australia.
出版信息
BMC Fam Pract. 2020 Oct 28;21(1):220. doi: 10.1186/s12875-020-01294-8.
BACKGROUND
Young people (12-24 years) visit general practice but may not have a 'regular' general practitioner (GP). Whether continuity of GP care influences experiences with, and barriers to, health care among young people is unknown. This paper explores the association between having a regular GP and experience of healthcare barriers and attitudes to health system navigation among young people in New South Wales (NSW), Australia.
METHODS
This study was a cross-sectional survey administered either online or face-to-face in community settings. Young people living in NSW were recruited, with oversampling of those from five socio-culturally marginalised groups (those who were Aboriginal and Torres Strait Islander, homeless, of refugee background, in rural or remote locations, sexuality and/or gender diverse). In this analysis of a larger dataset, we examined associations between having a regular GP, demographic and health status variables, barriers to health care and attitudes to health system navigation, using chi-square tests and odds ratios. Content and thematic analyses were applied to free-text responses to explore young people's views about having a regular GP.
RESULTS
One thousand four hundred and sixteen young people completed the survey between 2016 and 2017. Of these, 81.1% had seen a GP in the previous 6 months and 57.8% had a regular GP. Cost was the most frequently cited barrier (45.8%) to accessing health care generally. Those with a regular GP were less likely to cite cost and other structural barriers, feeling judged, and not knowing which service to go to. Having a regular GP was associated with having more positive attitudes to health system navigation. Free-text responses provided qualitative insights, including the importance of building a relationship with one GP.
CONCLUSIONS
General practice is the appropriate setting for preventive health care and care coordination. Having a regular GP is associated with fewer barriers and more positive attitudes to health system navigation and may provide better engagement with and coordination of care. Strategies are needed to increase the proportion of young people who have a regular GP.
背景
年轻人（12-24 岁）会去看全科医生，但他们可能没有“固定”的全科医生（GP）。在澳大利亚新南威尔士州（NSW），GP 连续性护理是否会影响年轻人的医疗体验和医疗服务障碍，以及他们对医疗系统导航的态度，目前尚不清楚。本文探讨了在 NSW，年轻人与拥有固定 GP 相关的医疗服务障碍和态度的经验，以及对医疗系统导航的态度。
方法
这是一项横断面调查，在社区环境中以在线或面对面的方式进行。招募居住在 NSW 的年轻人，并对来自五个社会文化边缘群体（原住民和托雷斯海峡岛民、无家可归者、难民背景、农村或偏远地区、性和/或性别多样化）的年轻人进行了超额抽样。在对更大数据集的分析中，我们使用卡方检验和优势比检验了拥有固定 GP 与人口统计学和健康状况变量、医疗服务障碍和对医疗系统导航态度之间的关联。内容和主题分析应用于自由文本回复，以探讨年轻人对拥有固定 GP 的看法。
结果
2016 年至 2017 年间，有 1416 名年轻人完成了调查。其中，81.1%的人在过去 6 个月内看过 GP，57.8%的人有固定 GP。费用是普遍获得医疗服务的最常见障碍（45.8%）。那些有固定 GP 的人不太可能提到费用和其他结构性障碍、感到被评判以及不知道该去哪个服务机构。拥有固定 GP 与对医疗系统导航有更积极的态度相关。自由文本回复提供了定性见解，包括与一位 GP 建立关系的重要性。
结论
全科医疗是预防保健和护理协调的适当场所。拥有固定 GP 与较少的障碍和更积极的医疗系统导航态度相关，并且可能提供更好的参与和护理协调。需要采取策略来增加有固定 GP 的年轻人比例。
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