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新冠疫情期间,患者对初级保健服务受限的住院医师的体验。

Patient experience of residents with restricted primary care access during the COVID-19 pandemic.

机构信息

Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan

Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

出版信息

Fam Med Community Health. 2022 Jun;10(2). doi: 10.1136/fmch-2022-001667.

Abstract

OBJECTIVES

To evaluate primary care access for COVID-19 consultation among residents who have a usual source of care (USC) and to examine their associations with patient experience during the pandemic in Japan.

DESIGN

Nationwide cross-sectional study.

SETTING

Japanese general adult population.

PARTICIPANTS

1004 adult residents who have a USC.

MAIN OUTCOME MEASURES

Patient experience assessed by the Japanese version of Primary Care Assessment Tool Short Form (JPCAT-SF).

RESULTS

A total of 198 (19.7%) reported restricted primary care access for COVID-19 consultation despite having a USC. After adjustment for possible confounders, restricted primary care access for COVID-19 consultation was negatively associated with the JPCAT-SF total score (adjusted mean difference = -8.61, 95% CI -11.11 to -6.10). In addition, restricted primary care access was significantly associated with a decrease in all JPCAT-SF domain scores.

CONCLUSIONS

Approximately one-fifth of adult residents who had a USC reported restricted primary care access for COVID-19 consultation during the pandemic in Japan. Our study also found that restricted primary care access for COVID-19 consultation was negatively associated with a wide range of patient experience including first contact. Material, financial and educational support to primary care facilities, the spread of telemedicine and the application of a patient registration system might be necessary to improve access to primary care during a pandemic.

摘要

目的

评估在日本大流行期间有常规医疗服务(USC)的居民对 COVID-19 咨询的初级保健可及性,并探讨其与患者体验的关联。

设计

全国性横断面研究。

地点

日本普通成年人群。

参与者

1004 名有 USC 的成年居民。

主要结局指标

使用初级保健评估工具短表(JPCAT-SF)评估患者体验。

结果

尽管有 USC,但共有 198 人(19.7%)报告 COVID-19 咨询的初级保健可及性受到限制。在调整可能的混杂因素后,COVID-19 咨询的初级保健可及性受限与 JPCAT-SF 总分呈负相关(调整后的平均差异=-8.61,95%CI-11.11 至-6.10)。此外,初级保健可及性受限与所有 JPCAT-SF 领域评分的降低显著相关。

结论

在日本大流行期间,大约五分之一有 USC 的成年居民报告 COVID-19 咨询的初级保健可及性受到限制。我们的研究还发现,COVID-19 咨询的初级保健可及性受限与广泛的患者体验呈负相关,包括首次接触。可能需要向初级保健设施提供物质、财政和教育支持、远程医疗的普及以及应用患者登记系统,以改善大流行期间的初级保健可及性。

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