Li Wenyu, Hou Yanqiu, An Jiayu, Chen Linxuan, Lu Shan
School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
Research Centre for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, People's Republic of China.
Risk Manag Healthc Policy. 2024 Sep 7;17:2151-2160. doi: 10.2147/RMHP.S474933. eCollection 2024.
The objective of this study was to explore the connection between family doctor contract services and preventable hospitalizations. Additionally, we sought to examine the role of primary health care quality as a mediating factor in the link between family doctor contract services and preventable hospitalizations among patients with hypertension.
This cross-sectional study was performed in Dangyang (Hubei Province, Central China) and Xishui (Guizhou Province, Western China) counties in July-August 2023. Participants comprised 625 patients selected via a multi-stage sampling method. Causal mediation analysis was conducted to explore the effect of family doctor contract services on preventable hospitalizations and the mediating effect of primary healthcare quality on this relationship.
Utilization rate of family doctor contract services of hypertensive patients was 58.6%, score of primary health service quality was 70.75 and incidence of preventable hospitalizations was 28.2%. Amongst hypertensive patients, utilization of family doctor contract services decreased the occurrence of preventable hospitalizations, with a total effect of -0.22 (p < 0.001). Primary healthcare quality mediates the association, with a mediate effect of -0.05 (p < 0.001), explaining 22.73% of the total effect.
Improving the utilization of family doctor contract services and primary healthcare quality may result in lower rates of preventable hospitalizations amongst hypertensive patients.
本研究旨在探讨家庭医生签约服务与可避免住院之间的联系。此外，我们试图检验初级卫生保健质量作为家庭医生签约服务与高血压患者可避免住院之间联系的中介因素的作用。
本横断面研究于2023年7月至8月在中国中部湖北省当阳市和中国西部贵州省习水县进行。参与者包括通过多阶段抽样方法选取的625名患者。进行因果中介分析以探讨家庭医生签约服务对可避免住院的影响以及初级卫生保健质量对这种关系的中介作用。
高血压患者家庭医生签约服务利用率为58.6%，初级卫生服务质量得分为70.75，可避免住院发生率为28.2%。在高血压患者中，家庭医生签约服务的使用降低了可避免住院的发生率，总效应为-0.22（p<0.001）。初级卫生保健质量起中介作用，中介效应为-0.05（p<0.001），解释了总效应的22.73%。
提高家庭医生签约服务的利用率和初级卫生保健质量可能会降低高血压患者的可避免住院率。
