Groenewegen Peter P, Kroneman Madelon, Spreeuwenberg Peter
NIVEL (Netherlands Institute for Health Services Research), PO box 1568, 3500BN, Utrecht, The Netherlands.
Department of Sociology and Department of Human Geography, Utrecht University, P.O. Box 80.115, 3508, TC, Utrecht, The Netherlands.
BMC Health Serv Res. 2021 Feb 1;21(1):107. doi: 10.1186/s12913-021-06120-0.
Primary care is the first point of care, also for people with disabilities. The accessibility of primary care facilities is therefore very important. In this study we analysed comparative data on physical accessibility of general practices (GP practices) in 31 (mainly) European countries.
We used data from the QUALICOPC study, conducted in 2011 among GPs in 34 (mainly European) countries and constructed a physical accessibility scale. We applied multilevel analysis to assess the differences between and within countries and to test hypotheses, related to characteristics of the practices and of the countries.
We found large differences between countries and a strong clustering of physical accessibility within countries. Physical accessibility was negatively related to the age of the GPs, and was less in single-handed and in inner city practices. Of the country variables only the length of the period of social democratic government participation during the previous decades was positively related to physical accessibility.
A large share of the variation in physical accessibility of GP practices was on the level of countries. This means that national policies can be used to increase physical accessibility of GP practices.
初级保健是医疗服务的第一站,对残疾人来说也是如此。因此,初级保健设施的可达性非常重要。在本研究中,我们分析了31个(主要是)欧洲国家全科医疗诊所(GP诊所)物理可达性的比较数据。
我们使用了2011年在34个(主要是欧洲)国家的全科医生中进行的QUALICOPC研究的数据,并构建了一个物理可达性量表。我们应用多层次分析来评估国家之间和国家内部的差异,并检验与诊所和国家特征相关的假设。
我们发现国家之间存在很大差异,并且在国家内部物理可达性存在很强的聚集性。物理可达性与全科医生的年龄呈负相关,在单人执业和市中心诊所中较低。在国家变量中,只有前几十年社会民主政府参与的时长与物理可达性呈正相关。
全科医疗诊所物理可达性的很大一部分差异存在于国家层面。这意味着可以利用国家政策来提高全科医疗诊所的物理可达性。