Feng Yan, Gravelle Hugh
Institute of Population Health Sciences, Queen Mary University of London, England, UK.
Centre for Health Economics, University of York, England, UK.
Value Health. 2021 Nov;24(11):1660-1666. doi: 10.1016/j.jval.2021.05.019. Epub 2021 Sep 10.
To examine the association of self-reported health of patients in general practices, as measured by the EQ-5D-5L, with practice clinical quality and patient-reported satisfaction with accessibility and consultations.
We used data from the General Practitioner (GP) Patient Survey to construct a practice-level EQ-5D-5L index as the health outcome. Key explanatories were patient-reported measures of satisfaction with access and consultations (also derived from the GP Patient Survey) and clinical quality measured by the achievement of clinical quality indicators reported in the Quality and Outcomes Framework. We estimated practice-level linear panel data models with random and fixed practice effects and practice and patient covariates using 2012/13 to 2016/17 data on more than 7500 English general practices.
Bivariate correlations of the EQ-5D-5L index with quality measures were 0.048 for clinical quality, 0.071 for satisfaction with access, and 0.107 for satisfaction with GP consultations (all with P<.001). In both fixed effects regressions, which allow for unobserved time invariant practice characteristics, and random effects regressions which do not, the EQ-5D-5L index was positively associated with 1-year lags of patient satisfaction with access and GP consultations. Patient-reported health was positively associated with clinical quality in the fixed effects regressions. The implied effects were small in all cases.
Practice-level EQ-5D-5L is positively associated with clinical quality and with 1-year lags of patient-reported satisfaction with access and GP consultations.
通过EQ-5D-5L量表衡量，研究普通诊所患者自我报告的健康状况与诊所临床质量以及患者报告的就医便利性和诊疗满意度之间的关联。
我们使用了全科医生（GP）患者调查的数据来构建诊所层面的EQ-5D-5L指数作为健康结果。关键解释变量包括患者报告的就医便利性和诊疗满意度（同样来自GP患者调查），以及通过质量与结果框架中报告的临床质量指标达成情况衡量的临床质量。我们使用2012/13至2016/17年超过7500家英国普通诊所的数据，估计了包含随机和固定诊所效应以及诊所和患者协变量的诊所层面线性面板数据模型。
EQ-5D-5L指数与质量指标的二元相关性分别为：临床质量为0.048，就医便利性满意度为0.071，全科诊疗满意度为0.107（均P<0.001）。在考虑未观察到的时间不变诊所特征的固定效应回归以及不考虑这些特征的随机效应回归中，EQ-5D-5L指数均与患者就医便利性满意度和全科诊疗满意度的1年滞后呈正相关。在固定效应回归中，患者报告的健康状况与临床质量呈正相关。所有情况下的隐含效应都很小。
诊所层面的EQ-5D-5L与临床质量以及患者报告的就医便利性和全科诊疗满意度的1年滞后呈正相关。
