Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania.
Hospital of Lithuanian University of Health Sciences Kauno Klinikos, LT-50161 Kaunas, Lithuania.
Medicina (Kaunas). 2023 Jan 31;59(2):276. doi: 10.3390/medicina59020276.
: Although multimorbidity poses many challenges for both individuals and healthcare systems, information on how these patients assess the quality of their healthcare is lacking. This study assessed the multimorbid patients' satisfaction with their healthcare. : This cross-sectional study was a part of a project Joint Action-Chronic Diseases and Promoting Healthy Ageing across the Life Cycle and its implementation. The study included 400 patients with arterial hypertension and at least one concomitant chronic disease. Patients completed The Patient Assessment of Care for Chronic Conditions Plus (PACIC+) questionnaire, EuroQol Five-Dimensions-Three-Level Quality of Life questionnaire, and Hospital Anxiety and Depression scale. : The mean age of the participants was 65.38 years; there were 52.5% women. The mean PACIC+ 5As summary score was 3.60. With increasing age, participants rated worse on most PACIC+ subscales. Participants who assessed their quality of life as worse were also less satisfied with their healthcare. The presence of three or more concomitant diseases negatively affected PACIC+ scores. Patients with ischemic heart disease and heart failure had lower PACIC+ scores on most subscales, whereas patients with atrial fibrillation had lower scores only on the Agree subscale. The presence of diabetes was not associated with worse PACIC+ scores; moreover, the scores in Assist and Arrange subscales were even better in diabetic patients (3.36 vs. 2.80, = 0.000 and 3.69 vs. 3.13, = 0.008, respectively). Patients with chronic obstructive pulmonary disease, asthma, and musculoskeletal disorders showed lower PACIC+ scores. : Older age, worse self-assessed health state, presence of three or more diseases, and certain chronic diseases were associated with lower patients' satisfaction with their healthcare. Personalized healthcare, increasing competencies of primary healthcare teams, healthcare services accessibility, and financial motivation of healthcare providers may increase multimorbid patients' satisfaction with their healthcare.
虽然多病共存给个人和医疗保健系统带来了许多挑战，但关于这些患者如何评估其医疗保健质量的信息却很缺乏。本研究评估了多病共存患者对其医疗保健的满意度。
这项横断面研究是联合行动-慢性病和促进全生命周期健康老龄化项目及其实施的一部分。研究纳入了 400 名患有动脉高血压和至少一种合并慢性疾病的患者。患者完成了慢性病患者护理评估加项（PACIC+）问卷、欧洲五维健康量表-三水平问卷和医院焦虑抑郁量表。
参与者的平均年龄为 65.38 岁，女性占 52.5%。PACIC+ 5A 综合评分平均得分为 3.60。随着年龄的增长，大多数 PACIC+子量表的评分都变差。自我评估健康状况较差的患者对医疗保健的满意度也较低。同时患有三种或三种以上合并疾病会对 PACIC+评分产生负面影响。患有缺血性心脏病和心力衰竭的患者在大多数子量表上的 PACIC+评分较低，而患有心房颤动的患者仅在同意子量表上的评分较低。糖尿病的存在与 PACIC+评分较差无关；此外，糖尿病患者在协助和安排子量表上的评分甚至更好（3.36 比 2.80， = 0.000 和 3.69 比 3.13， = 0.008）。患有慢性阻塞性肺疾病、哮喘和肌肉骨骼疾病的患者的 PACIC+评分较低。
年龄较大、自我评估健康状况较差、同时患有三种或三种以上疾病以及某些慢性疾病与患者对其医疗保健的满意度较低有关。个性化医疗保健、提高初级保健团队的能力、医疗保健服务的可及性以及医疗保健提供者的经济激励措施可能会提高多病共存患者对其医疗保健的满意度。
