Dunt D R, Oberklaid F, Temple-Smith M J
Department of Community Medicine, University of Melbourne, Parkville, Victoria, Australia.
Aust Paediatr J. 1988 Apr;24(2):132-7. doi: 10.1111/j.1440-1754.1988.tb00305.x.
An interview study investigating attitudinal and other factors influencing the selection of primary medical care (PMC) is described. It focuses on parents of sick children, excluding those with trauma or medical/surgical emergencies, and was conducted in part of the Western Region (WR) of Melbourne in late 1983, the period immediately prior to the introduction of Medicare. It is based on a cross-sectional survey of in-hours attenders of eight general practices (GP), the Western Region Community Health Centre (WRCHC), the general clinic of the casualty departments at the Western General Hospital (WGH), and the Royal Children's Hospital (RCH), a teaching hospital outside the region. The most commonly stated reasons for attendance at services generally were 'closeness to home/work', 'recommendation' and 'good service'. 'Cheap/economic reasons' were given less frequently overall than the above reasons. There were however some differences in reasons given by attenders at different places of care. 'Cheap/economic reasons' was offered significantly more often and 'recommendation' significantly less often by WGH attenders compared with other attenders. 'Specialists available' and 'dissatisfaction with other doctors' was offered significantly more frequently and 'close to home' and 'no other doctor' significantly less frequently by RCH attenders than other attenders. Health insurance status did not differ significantly at the different places of care. Attenders of the RCH were significantly more knowledgeable about community health centres than GP or WGH attenders. Non-GP attenders had more often used other than their current place of care for treatment in the recent past than GP attenders had.(ABSTRACT TRUNCATED AT 250 WORDS)
本文描述了一项访谈研究,该研究调查了影响初级医疗保健(PMC)选择的态度及其他因素。研究聚焦于患病儿童的家长,排除了有创伤或医疗/外科急症的儿童家长,于1983年末在墨尔本西部地区(WR)的部分地区进行,该时期恰好在医疗保险引入之前。研究基于对八家全科诊所(GP)、西部地区社区健康中心(WRCHC)、西部综合医院(WGH)急诊科普通诊所及该地区外的教学医院皇家儿童医院(RCH)的非急诊就诊者的横断面调查。一般来说,就诊服务最常提及的原因是“离家/工作地点近”“推荐”和“服务好”。总体而言,“便宜/经济原因”的提及频率低于上述原因。然而,不同医疗机构的就诊者给出的原因存在一些差异。与其他就诊者相比,WGH的就诊者提及“便宜/经济原因”的频率显著更高,提及“推荐”的频率显著更低。与其他就诊者相比,RCH的就诊者提及“有专家”和“对其他医生不满意”的频率显著更高,提及“离家近”和“没有其他医生”的频率显著更低。不同医疗机构就诊者的医疗保险状况没有显著差异。与GP或WGH的就诊者相比,RCH的就诊者对社区健康中心的了解明显更多。非GP就诊者在近期使用当前就诊机构以外的其他机构进行治疗的频率高于GP就诊者。(摘要截选至250词)