Mohr Nicole, Langenbruch Anna, Augustin Jobst, Kirsten Natalia, Augustin Matthias, Andrees Valerie
Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany.
Res Health Serv Reg. 2022 Aug 30;1(1):8. doi: 10.1007/s43999-022-00008-0.
Large variations in the quality of psoriasis care lead to patients being willing to bypass the nearest physician to receive higher quality of care. However, it remains unknown whether actual travel time is associated with quality of care. This study aimed to identify perceived quality of care determinants for travel time to the physician among patients with psoriasis in Germany. Furthermore, differences in access and perceived quality of care between urban and rural areas in Germany were analyzed.
This cross-sectional observational study based on patient-level healthcare data. Perceived quality of care and treatment satisfaction were assessed from the patients' perspective. Travel time was estimated by the patients. Multiple regression analysis with the predictors patient characteristics, system-related variables, urbanity, and patient satisfaction with treatment, was applied to identify determinants of travel time with subgroup analyses for rural and urban areas.
We included 497 patients from 29 dermatological practices in Germany. There were significant differences in psoriasis care between urban and rural areas. Longer travel time was associated with lower age, higher income, higher number of consulted dermatologists since diagnosis, rural residence, more waiting time for the first appointment, lower dermatologist density, and higher patient reported treatment satisfaction.
The results indicate an association between actual travel time and treatment satisfaction. Patients with higher perceived quality of care travel longer for their dermatological treatment. The results are also relevant to needs related planning.
银屑病护理质量存在很大差异，导致患者愿意绕过最近的医生去接受更高质量的护理。然而，实际出行时间是否与护理质量相关仍不清楚。本研究旨在确定德国银屑病患者前往就医的出行时间的护理质量感知决定因素。此外，还分析了德国城乡地区在医疗服务可及性和护理质量感知方面的差异。
本横断面观察性研究基于患者层面的医疗数据。从患者角度评估护理质量感知和治疗满意度。出行时间由患者估计。采用多元回归分析，以患者特征、系统相关变量、城市化程度和患者对治疗的满意度为预测因素，确定出行时间的决定因素，并对农村和城市地区进行亚组分析。
我们纳入了德国29家皮肤科诊所的497名患者。城乡地区的银屑病护理存在显著差异。出行时间较长与年龄较小、收入较高、确诊后咨询皮肤科医生的次数较多、居住在农村、首次预约等待时间较长、皮肤科医生密度较低以及患者报告的治疗满意度较高有关。
结果表明实际出行时间与治疗满意度之间存在关联。护理质量感知较高的患者在皮肤科治疗时出行距离更远。这些结果也与需求相关规划有关。
