School of Population Health and Environmental Sciences, King's College London, London.
Centre for Health Economics, University of York, York.
Br J Gen Pract. 2020 Dec 28;71(702):e47-e54. doi: 10.3399/bjgp21X714233. Print 2021 Jan.
Providing high-quality clinical care and good patient experience are priorities for most healthcare systems.
To understand the relationship between general practice funding and patient-reported experience.
Retrospective longitudinal study of English general practice-level data for the financial years 2013-2014 to 2016-2017.
Data for all general practices in England from the General and Personal Medical Services database were linked to patient experience data from the GP Patient Survey (GPPS). Panel data multivariate regression was used to estimate the impact of general practice funding (current or lagged 1 year) per patient on GPPS-reported patient experience of access, continuity of care, professionalism, and overall satisfaction. Confounding was controlled for by practice, demographic, and GPPS responder characteristics, and for year effects.
Inflation-adjusted mean total annual funding per patient was £133.66 (standard deviation [SD] = £39.46). In all models, higher funding was associated with better patient experience. In the model with lagged funding and practice fixed effects (model 6), a 1 SD increase in funding was associated with increases in scores in the domains of access (1.18%; 95% confidence interval [CI] = 0.89 to 1.47), continuity (0.86%; 95% CI = 0.19 to 1.52), professionalism of GP (0.47%; 95% CI = 0.22 to 0.71), professionalism of nurse (0.51%; 95% CI = 0.24 to 0.77), professionalism of receptionist (0.51%; 95% CI = 0.24 to 0.78), and in overall satisfaction (0.88%; 95% CI = 0.52 to 1.24).
Better-funded general practices were more likely to have higher reported patient experience ratings across a wide range of domains.
为大多数医疗保健系统提供高质量的临床护理和良好的患者体验是重中之重。
了解一般实践资金与患者报告的体验之间的关系。
对 2013-2014 财政年度至 2016-2017 财政年度的英国一般实践水平数据进行回顾性纵向研究。
从一般和个人医疗服务数据库中链接英格兰所有一般实践的数据，并与 GP 患者调查（GPPS）中的患者体验数据相关联。使用面板数据多变量回归来估计每位患者的一般实践资金（当前或滞后 1 年）对 GPPS 报告的患者在获得、护理连续性、专业性和整体满意度方面的影响。通过实践、人口统计学和 GPPS 应答者特征以及年度效果来控制混杂因素。
经通胀调整后的每位患者的年平均总资金为 133.66 英镑（标准差 [SD] = 39.46 英镑）。在所有模型中，较高的资金与更好的患者体验相关。在具有滞后资金和实践固定效应的模型中（模型 6），资金增加 1 个标准差与获得（1.18%；95%置信区间 [CI] = 0.89 至 1.47）、连续性（0.86%；95%CI = 0.19 至 1.52）、GP 的专业性（0.47%；95%CI = 0.22 至 0.71）、护士的专业性（0.51%；95%CI = 0.24 至 0.77）、接待员的专业性（0.51%；95%CI = 0.24 至 0.78）和整体满意度（0.88%；95%CI = 0.52 至 1.24）的评分增加相关。
资金充足的一般实践更有可能在广泛的领域获得更高的报告患者体验评分。
